Histopathological Analysis: Objective Or Subjective?

Published 2022 - 40th Congress of the ESCRS

Reference: PO073 | Type: ESCRS 2022 - Posters | DOI: 10.82333/ha7x-s672

Authors: Ivana Radman* ¹ , Ivanka Petric Vicković ¹ , Valentina Lacmanović Lončar ¹ , Iva Krolo ² , Sanja Poduje ³ , Leo Pažanin ⁴ , Tomislav Orešić ⁵ , Zoran Vatavuk ¹

¹Ophtalmology Clinic,University Hospital Center "Sestre milosrdnice",Zagreb,Croatia, ²Optical Express Group,University Hospital Center "Sestre milosrdnice",Zagreb,Croatia, ³Dermatology Clinic,University Hospital Center "Sestre milosrdnice",Zagreb,Croatia, ⁴Patology Clinic,University Hospital Center "Sestre milosrdnice",Zagreb,Croatia, ⁵Surgery Clinic,University Hospital Center "Sestre milosrdnice",Zagreb,Croatia

Purpose

Can we easily make diference between malignant and benign lesions clinicaly and by slit lamp examinations? It is very important first of all history regarding lesion characteristics (appearance ,duration, accompanying symptoms) and clinical examination with slit lamp biomicroscopy that indludes this few parameters..... The most important is color photograph which is useful in detecting progression these lesions..Without histopathological evaluation it is impossible to make a diagnosis. A 46-year-old woman presented on September 2014 to other institution with pigmented qrowth of left conjunctiva. Examination showed pigmented nevus of bulbar conjunctiva affecting limbus with irregular margins and increased vascularity

Setting

Conjuctival melanoma is a rare malign tumor, affecting 0.25% of all melanomas (2). It metastasis in 26-40% of cases. Pathohystological and Immunohystochemical analysis are important for making a diagnosis. So, in order to make a precises diagnosis it is of vital importance that all lesions are surgically excised and subjected to histopathological analysis. Men are more frequently affected than women. They most commonly arise from melanocytes located in choroidea, uvea, conjunctiva etc.

Methods

The lesion has been known since childhood with no changes until few month ago when started to grow.The patient was reffered to oncologist who adviced control examinations every 3 months. On July 2016 mild progression was registered and surgical excision suggested. Patient was reffered to our institution on October 2016. for second opinion. Considering the progress we have decided to make histopathological revision of sample from 2014. Histopathological revison showed conjunctival melanom

Results

Histopathological examination confirmed diagnosis of conjunctival melanoma. Atypical melanocytes were S 100, HMB45 and Melan A positive infiltrating subepethelial stromaOne month following the therapy examination showed complete clinical resolution of the lesion. The patient has now been followed-up for 19 month with no signs of of recurrence or metastasis. Melanocytic lesions of conjunctiva are nevi. acquired melanosis and conjunctival melanoma. Prognosis of conjuntival melanoma is poor. Timely diagnosis and therapy could be of crucial significance. Thus, all suspicious lesions should be surgically excised and subjected to histopathological analysis

Conclusions

A histopathological examination plays a key role in determination whether a pigmented conjunctival tumor is a nevus, acquired melanosis or a conjunctival melanoma. Thus, all suspicious lesions should be surgically excised and subjected to histopathological analysis.