Abstract

SO.07.04

Metastasis of conjunctival melanoma

Lothar Krause1, Anta Mladenowa2, Michael H. Foerster2
1Augenklinik, Städtisches Klinikum Dessau, Dessau, 2Augenklinik, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Berlin

Objective
The malignant melanoma of the conjunctiva is a rare potentially lethal neoplasm. Its incidence is 0.2 to 0.8 per million in the western population without sexual predilection. The average 10-year tumour related survival is 70%. Metastases may occur hämatogen, lymphatic or in the surrounding. A special feature of these Tumours is the possibility of metastases through the ductus nasolacrimalis.
Patients: We reviewed the records of 57 consecutive patients who underwent surgical excision between 1991-2007.
Methods
The diagnosis was histological verified and the following parameters were assessed: age (at the data of diagnosis), sex (m, w), eye (OD, OS), tumour growth because of primary acquired melanosis (PAM), de novo, developing from a naevus, rate of reccurence (time to first reccurence) and the rate of metastases. There were a wide range of treatments available (surgery, brachytherapy with ruthenium and strontium plaque, cryotherapy, mitomycin C, external irradiation, proton beam irradiation.
Results
In 32(56%) cases were no presence of recurrence. In 12(21%) cases the presence of recurrence. 13(22%) patients had recurrence in another localisation. 10(17%) patients developed metastases. In 5(8%) cases clinical metastases occurred first to the neck lymph nodes. In 5(8%) systemic dissemination occurred to other organs without prior clinical evidence of regional lymph node involvement. 3(5%) patients had metastases in the lacrimal ducts. 2(4%) patients had a metastatic
Conclusions
The development of metastases is a predicting factor for the tumour related survival. The initial excision and adjuvant brachytherapy may be curative. Patients need to be reviewed on a regular basis to detect recurrence at an early stage.

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