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104. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft 2006
Abstract
Abstract
SO.14.14 Malignant melanoma of the conjunctiva Maier P., Reinhard T.
University Eye Hospital Freiburg Conjunctival melanoma is a relatively rare malignancy of the ocular surface with substantial associated morbidity and mortality. Its incidence is 0.2 to 0.8 cases per million in white populations. Early identification of this potentially letal lesion and the following adequate treatment are crucial as the 10-year mortality rate is estimated up to 30%. Therefore, recognition of potential precursor lesions like primary acquired melanosis with atypia and atypical nevi at an early stage is important. Conjunctival melanoma is identified most frequently in the perilimbal interpalpebral bulbar conjunctiva with tumors located in the palpebral or fornical conjunctiva or caruncle, plica semilunaris or eyelid margins having a worse prognosis for survival. Clinical metastases usually occur first to the lymph nodes with medial tumors often spreading to the submandibular area and the lateral lesions to the preauricular region. Staging of the disease by sentinel lymph node identification and biopsy may be helpful for planning optimal treatment regimens. A combination of surgical excision of nodular tumors with cryotherapy to the underside of the adjacent conjunctival margins or intaoperative topical mitomycin C may be effective in eradicating these lesions. Some cases may require radiation therapy in the form of brachytherapy (eg, with strontium plaques). In advanced cases (e.g., deeply invasive and multifocal tumors), exenteration of the orbital contents may be the only option, although by this stage systemic spread of the tumor has frequently occurred, resulting in no effect on the prognosis for survival. We present our experiences with this malignant tumor in 8 cases which have presented at our institution during the last 3 years.
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