[A single-center study on the distribution patterns and clinicopathological characteristics of conjunctival tumors...

Objective: To investigate the distribution patterns, clinicopathological characteristics, and age-specific trends of conjunctival tumors in a single center from June 2018 to December 2023, and to analyze their changes compared with historical data. Methods: This was a retrospective case series study. A total of 1 413 histopathological cases of excised conjunctival lesions from the Second Affiliated Hospital of Zhejiang University School of Medicine between June 2018 and December 2023 were enrolled as the study cohort. All cases underwent histopathological classification, with partial specimens supplemented by immunohistochemical staining, special staining, or electron microscopy. The histopathological types (epithelial, melanocytic, inflammatory lesions, etc.), lesion nature (benign, premalignant, or malignant), and age distribution (children and adolescents, ≤18 years; young-middle-aged adults, 19 to 59 years; the elderly, ≥60 years) of these cases were compared with those of 1 233 historical cases (January 2000 to May 2018). Results: Among 1 216 eligible cases, there were 567 males and 649 females, with 1 052 benign lesions (86.51%) and 164 premalignant/malignant lesions (13.49%). Histopathologically, epithelial tumors (508 cases, 41.86%) and melanocytic tumors (433 cases, 35.59%) were predominant, followed by inflammatory lesions (118 cases, 9.70%), lymphoproliferative lesions (59 cases, 4.85%), and vascular tumors (55 cases, 4.52%). Benign lesions were dominated by cysts (323 cases, 26.56%) and nevi (314 cases, 25.82), while premalignant/malignant lesions were primarily conjunctival intraepithelial neoplasia (68 cases, 5.59%) and lymphoma (40 cases, 3.29%). Compared with historical data, the study cohort showed a significantly higher proportion of benign lesions (86.51% vs. 78.48%) and a lower proportion of premalignant/malignant lesions (13.49% vs. 21.52%). The proportion of cysts increased from 12.89% to 26.56% (becoming the most common benign lesion), while squamous papilloma decreased from 10.52% to 6.74%. In age distribution, young-middle-aged adults accounted for 62.83% (764 cases) in the study cohort (slightly higher than 60.00% in historical cases), and the elderly accounted for 23.19% (282 cases) (slightly lower than 24.27%). Conclusions: Analysis of single-center data from 2018 to 2023 revealed an increased proportion of benign conjunctival lesions and a decreased proportion of premalignant/malignant lesions, with epithelial and melanocytic tumors remaining predominant but inflammatory lesions decreasing. Children, adolescents, and young-middle-aged adults primarily presented with cystic and nevus-like benign lesions, while the elderly, also showing benign lesions, had a significantly higher proportion of premalignant/malignant lesions.