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Conjunctival Tumours.ppt
- 1. 1. Benign • Naevus • Papilloma • Epibulbar dermoid • Lipodermoid 2. Pre-malignant • Primary acquired melanosis ( PAM ) • Intraepithelial neoplasia (carcinoma in situ) 3. Malignant • Melanoma • Squamous cell carcinoma • Kaposi sarcoma • Lymphoma CONJUNCTIVAL TUMOURS
- 2. Naevus • 30% are almost non-pigmented • Most frequently juxtalimbal • Sharply demarcated and slightly elevated • Presents in first two decades
- 3. Papilloma Pedunculated Sessile • Presents in middle age • Not caused by infection • Single and unilateral • Presents in childhood or early adulthood • Infection with papilloma virus • May be multiple and bilateral
- 4. • Presents in childhood • Smooth, soft mass • Usually juxtalimbal • Occasionally Goldenhar syndrome Epibulbar dermoid Signs Association
- 5. Lipodermoid • Presents in adulthood • Soft, movable, subconjunctival mass • Most frequently at outer canthus
- 6. Intraepithelial neoplasia (carcinoma in situ) • Juxtalimbal fleshy avascular mass • May become vascular and extend onto cornea • Presents in late adulthood • Malignant transformation is uncommon Signs Progression
- 7. Primary acquired melanosis (PAM) • PAM without atypia is benign • PAM with atypia is pre-malignant • Unilateral, irregular areas of flat, brown pigmentation • May involve any part of conjunctiva • Presents in late adulthood Signs Types
- 8. Conjunctival melanoma From PAM with atypia • Sudden appearance of nodules in PAM From naevus • Sudden increase in size or pigmentation Primary • Solitary nodule • Frequently juxtalimbal but may be anywhere • Very rare • Most common type
- 9. Localized tumour • Excision Treatment of conjunctival melanoma Diffuse tumour • Excision of nodules Orbital recurrence • Excision and radiotherapy • Adjunctive cryotherapy or mitomycin C • Exenteration • Adjunctive cryotherapy
- 10. Squamous cell carcinoma • Rarely metastasizes • Arises from intraepithelial neoplasia or de novo • Frequently juxtalimbal • Slow-growing • Presents in late adulthood • May spread extensively Signs Progression
- 11. Kaposi sarcoma • Most frequently in inferior fornix • Affects patients with AIDS • Vascular, slow-growing tumour of low malignancy • Very sensitive to radiotherapy
- 12. Lymphoma • Salmon-coloured, subconjunctival infiltrate • Usually presents in adulthood • Benign or malignant