Type de présentation | E-poster |
Titre | Surgical management of conjunctival melanoma with corneal invasion |
But | We present the surgical management of 2 cases of conjunctival melanoma with corneal invasion. |
Méthodes | Two patients were treated for a large conjunctival melanocytic lesion. |
Résultats | Both tumours were surgically removed using a no-touch technique. Because of corneal invasion, an intrastromal cleavage plane was created using a diamond micrometer blade. Alcohol w as applied to the corneoscleral bed and conjunctival margins were treated with cryotherapy. The defect was closed using an amniotic membrane patch graft in 1 patient, a corneoscleral patch graft was necessary to close the defect in the second patient. Pathology confirmed the diagnosis of malignant conjunctival melanoma. One of the patients underwent 3 cycles of adjuvant topical 5FU 1% because of neoplastic cells invading one of the surgical margins. Staging included whole body PET-CT, blood examination and MRI, which were all negative. Both patients had a normal postoperative recovery, including absence of inflammation, complete epithelial closure and functional vision. There is no evidence of local recurrence or metastasis to date, more than one year postop. |
Conclusion | Although infrequent, conjunctival melanoma is a potentially fatal malignancy. Exenteration is still performed to treat large invasive conjunctival melanomas, however it failed to improve overall survival. This case series illustrates that excellent anatomical and visual outcomes can be obtained, using a no-touch corneoscleral lamellar excision with immediate ocular surface reconstruction. |
Conflit d'intérêt | Non |
Nom | DEPRAETERE |
Initiales | C |
Institut | Dpt of Ophthalmology, Ghent University Hospital |
Ville | Ghent |
Nom | ROELS |
Initiales | D |
Institut | Dpt of Ophthalmology, Ghent University Hospital |
Ville | Ghent |
Nom | VAN DORPE |
Initiales | J |
Institut | Dpt of Pathological Anatomy, Ghent University Hospital |
Ville | Ghent |