Clinicopathological Profile of Conjunctival Melanoma at a Referral Ophthalmology Center in Peru

Andrea Carolina Concha-Tuero,1 Carlos Alfonso Noel-Pallas,1 Claudia María Sánchez-Huamash,2 Erick Joffre Urbano-Ale,1 Jorge Ramiro Villalobos-Espinoza,1 Lelia Marroquín-Loayza,1 Marcos Espinola-Sánchez2,3 1Departamento de Atención Especializada en Apoyo al Diagnóstico y Tratamiento, Instituto Nacional de Oftalmología - INO, “Dr. Francisco Contreras Campos”, Lima, Peru; 2Dirección de Investigación y Docencia Especializada en Oftalmología y Desarrollo de Tecnologías, Instituto Nacional de Oftalmología - INO, “Dr. Francisco Contreras Campos, Lima, Peru; 3Facultad de Ciencias de la Salud, Universidad Privada del Norte, Lima, PeruCorrespondence: Andrea Carolina Concha-Tuero, Email [email protected]: To describe the clinicopathological profile of conjunctival melanoma in a referral ophthalmology center in Peru.Patients and Methods: Observational, descriptive, and retrospective study including 29 patients with conjunctival melanoma confirmed by histopathological examination, attended between 2012 and 2023 at the Instituto Nacional de Oftalmología “Dr. Francisco Contreras Campos”, Lima, Peru. The main variable was the clinicopathological profile, which comprised clinical characteristics (clinical course, topography, symptoms, and signs) and pathological characteristics (macroscopic and microscopic).Results: The mean age of patients was 60.4 ± 17.5 years, and 69% were female. Right eye involvement was observed in 58.6% of cases, and in 93.1% the melanoma was located in the bulbar conjunctiva. In 67.9%, the disease extended to several quadrants of the ocular surface; moreover, 87% did not show additional foci of pigmented lesions. Conjunctival melanoma presented with an irregular shape in 62.1% of cases, firm consistency in 58.6%, was melanotic in 100%, and was of medium size in 41.7%. In addition, the lesion originated from primary acquired melanosis (PAM) in 66.7% of cases and from a nevus in 27.8%.Conclusion: The clinicopathological profile revealed predominant involvement of the right eye, bulbar conjunctiva, multiple quadrants and pigmented medium-sized lesions.Plain Language Summary: Conjunctival melanoma is a rare eye cancer that develops from melanocytes. Melanocytes are pigment-producing cells found in both the skin and the eye. In the conjunctiva, they help give color and protect tissues from light damage. Although melanoma most commonly affects the skin, it can also arise in the conjunctiva, the thin membrane that covers the white part of the eye. In recent years, its incidence has gradually increased.This tumor may develop from a pre-existing pigmented lesion or appear on its own. It can behave aggressively. It may come back after treatment or spread to other parts of the body. In Peru, there is limited information about this disease. For this reason, we analyzed the clinical and pathological features of patients with conjunctival melanoma treated at a national referral ophthalmology center. Our goal was to improve understanding of this condition and support better diagnosis and management in clinical practice.Keywords: melanoma, conjunctival neoplasms, ophthalmology, neoplasms