Clinical and Pathological Features of Six Cases of Corneo-Conjunctival Malignant Melanoma

Objective: To summarize the clinical and pathological features of malignant ocular surface melanoma and study the treatment and prognosis. Methods: The clinical, pathological and follow-up data of 6 patients with ocular surface melanoma were collected from July 2006 to February 2013 in Southwest Hospital Affiliated the Third Military Medical University (Army Medical University). The pathological examinations were performed by HE staining of paraffin sections and immunohistochemical staining, which were used for detecting HMB-45 and S-100, respectively. Results: The 6 patients with ocular surface melanoma ranged in age from 13 to 76 years old, and averaged 56.4 years old. Five cases were monocular, while 1 case was binocular. Four patients had multiple centers and 2 had a single center. Total or partial lamellar keratoplasty was performed after the tumors were completely excised. Based on the scope of the tumor, the extended resections were 5 mm adjacent to the tumor in the conjunctiva and 2 mm in the cornea. The conjunctiva adjacent to the tumor were mostly infiltrated with tumor cells. The postoperative follow-up time ranged from 10 months to 8 years, average 51.6 months. Among the 6 patients, 4 experienced no recurrence, 1 developed homolateral mandibular and preauricular lymph node metastasis and 1 died from systemic metastasis. Conclusion: Malignant ocular surface melanoma is rare with a high malignancy and poor prognosis. Most pathological types of malignant ocular surface melanoma are epithelial cell types, early diagnosis and expanded resection is an important way to improve prognosis. Key words: corneo-conjunctival melanoma; malignant melanoma; diagnosis; treatment; prognosis