Conjunctival Nevus Excision
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Title: Conjunctival Nevus Excision
Authors: Russell Swan, MD; Mark Mifflin, MD
Date: 2/26/16
Keywords/Main Subjects: Conjunctival Nevus; Melanoma; Nevus;
Diagnosis: Conjunctival Nevus
Description of Video:
This case is from a 32 year old male who presented to the ophthalmology clinic for evaluation of a melanocytic lesion of his conjunctiva. This lesion had been noticeable to the patient since adolescence and was causing mild irritation as well as cosmetic frustration to the patient. After a discussion of the risk benefits and alternatives to surgical excision with the patient including continue observation the patient elected to proceed with excision. The video demonstrates a no-touch technique for removing a conjunctival lesion. Given extremely low suspicion of malignancy in this case (given history and appearance consistent with conjunctival nevus) only a 1mm rim of normal conjunctiva was excised with the lesion.
The review article by Shileds et al provides a nice overview of a large series of patients with giant (>1cm) conjunctival nevus. A few highlights worth mentioning:
- Average age of onset: 34
- M:F ratio: nearly 1:1
- Race: most commonly Caucasian, 88%
- Location:
- bulbar conjunctiva: 97%
- Forniceal conjunctiva: 28%
- Tarsal conjunctiva: 9%
- Caruncle: 22%
- Semilunar Fold: 31%
- Mean basal diameter: 16mm
- Percent transformation into melanoma: <1%
Format: video
References: Shileds, C. et al. Giant conjunctival nevus: clinical features and natural course in 32 cases. JAMA Ophthalmology 2013 Jul;131(7):857-63
Faculty Approval by: Mark Mifflin, MD
Identifier: Moran_CORE_20545
Copyright statement: Russell Swan, MD ©2015. For further information regarding the rights to this collection, please visit: http://morancore.utah.edu/terms-of-use/
