Hibba Quhill1, Paul A Rundle2, Hardeep Singh Mudhar3. 1. Department of Ophthalmology, Royal Hallamshire Hospital, Sheffield, UK. 2. Ocular Oncology Service, Royal Hallamshire Hospital, Sheffield, UK. 3. National Specialist Ophthalmic Pathology Service (NSOPS), Department of Histopathology, Royal Hallamshire Hospital, Sheffield, UK.
Abstract
PURPOSE OF THE STUDY: To describe an unusual brown pigmented lesion of the conjunctiva in an anophthalmic socket in a 16-year-old male. PROCEDURES: A 16-year-old male patient presented with socket irritation whilst wearing an artificial eye due to meibomian gland dysfunction. An area of flat, subepithelial, dark brown pigmentation with irregular and indistinct borders on the bulbar conjunctiva of the anophthalmic socket was seen. The patient believed it had been present for at least 2 years. His past ocular history was of childhood trauma to the right eye at the age of 9 years, and he underwent primary enucleation and hydroxyapatite orbital implant insertion at that time. Unfortunately, the implant extruded and was removed a year later. RESULTS: An incisional biopsy of the pigmented lesion showed a conjunctival, subepithelial bland spindle cell melanocytic lesion, with uniform-sized and -shaped melanosomes. Immunohistochemistry showed the cells to express Melan A and HMB45 and they were negative for CD68 and pan-cytokeratins. The features were of a common blue naevus. CONCLUSION: This is the first documentation of a post-enucleation conjunctival naevus in an anophthalmic socket. We propose a pathogenesis and suggest surveillance as there is a risk of transformation to melanoma.
PURPOSE OF THE STUDY: To describe an unusual brown pigmented lesion of the conjunctiva in an anophthalmic socket in a 16-year-old male. PROCEDURES: A 16-year-old male patient presented with socket irritation whilst wearing an artificial eye due to meibomian gland dysfunction. An area of flat, subepithelial, dark brown pigmentation with irregular and indistinct borders on the bulbar conjunctiva of the anophthalmic socket was seen. The patient believed it had been present for at least 2 years. His past ocular history was of childhood trauma to the right eye at the age of 9 years, and he underwent primary enucleation and hydroxyapatite orbital implant insertion at that time. Unfortunately, the implant extruded and was removed a year later. RESULTS: An incisional biopsy of the pigmented lesion showed a conjunctival, subepithelial bland spindle cell melanocytic lesion, with uniform-sized and -shaped melanosomes. Immunohistochemistry showed the cells to express Melan A and HMB45 and they were negative for CD68 and pan-cytokeratins. The features were of a common blue naevus. CONCLUSION: This is the first documentation of a post-enucleation conjunctival naevus in an anophthalmic socket. We propose a pathogenesis and suggest surveillance as there is a risk of transformation to melanoma.
Authors: Jong Hyun Kim; Min Joung Lee; Ho-Kyung Choung; Nam Ju Kim; Sang-won Hwang; Mi Sun Sung; Sang In Khwarg Journal: Ophthalmic Plast Reconstr Surg Date: 2008 Jul-Aug Impact factor: 1.746
Authors: Klaus J Busam; Yuqiang Fang; Suresh C Jhanwar; Melissa P Pulitzer; Brian Marr; David H Abramson Journal: J Cutan Pathol Date: 2010-02 Impact factor: 1.587