Overview
Conjunctival melanoma is a rare and potentially aggressive cancer that arises from melanocytes in the conjunctiva, the mucous membrane covering the eye and inner eyelids. It can arise de novo or from a pre-existing nevus or primary acquired melanosis (PAM).
Symptoms
- Pigmented or non-pigmented lesion on the conjunctiva
- Redness or irritation
- Localized thickening or mass
- Visual discomfort or foreign body sensation
- Regional lymph node swelling (advanced cases)
Causes & Risk Factors
- Pre-existing conjunctival nevus or PAM with atypia
- Excessive UV light exposure
- Light skin or eye color
- Age >50 years
- Rare familial or genetic predisposition
Diagnosis
- Slit-lamp exam and detailed ocular surface inspection
- Biopsy and histopathologic analysis
- Imaging (orbital MRI, PET/CT) for staging and invasion
- Sentinel lymph node biopsy in select cases
Treatment Options
- Wide local excision with “no-touch” technique
- Cryotherapy to surgical margins
- Topical chemotherapy (e.g., mitomycin C)
- Radiation therapy (brachytherapy or proton beam)
- Enucleation or orbital exenteration (advanced or recurrent disease)
Prognosis
- Recurrence rate ~30–50%
- Metastatic risk: ~20–30% (most commonly to lymph nodes and lungs)
- Prognosis depends on tumor thickness, location, and margin control
Living with this Cancer Type
- Regular eye and systemic cancer surveillance
- Use of sun protection (UV-blocking sunglasses)
- Visual and cosmetic rehabilitation if needed
- Psychological support for fear of recurrence
Prevention & Screening
- Monitoring of conjunctival nevi and PAM with atypia
- Early intervention for suspicious pigmented lesions
- Annual ocular exams, especially in high-risk individuals
FAQs
Q: Is conjunctival melanoma curable?
A：Yes, if detected early and completely excised, but it requires close monitoring.
Q: Can it spread?
A：Yes. It can metastasize to lymph nodes, lungs, and liver.
Q: How is it different from uveal melanoma?
A：It arises on the eye surface, not inside the eye.
Resources
- Ocular Melanoma Foundation
- American Academy of Ophthalmology (AAO)
- ClinicalTrials.gov
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