A Clinicopathologic Analysis of 75 Cases of Conjunctival Primary Acquired Melanosis
Objective:To investigate the clinicopathological features,pathological staging and differential diagnosis of conjunctival primary acquired melanosis(PAM).Methods:The clinical and pathological data of 75 patients with PAM were collected from January 2017 to September 2024 at Eye Hospital,Wenzhou Medical University.A comprehensive review of relevant literature was also conducted.Results:The 75 patients(mean age,38.6±16.0 years;range,17-87 years)included 24 males and 51 females,with a male-to-female ratio of 1∶2.PAM predominantly occurred in the bulbar conjunctiva(69 cases),with rare involvement of the palpebral conjunctiva(1 case),the lacrimal caruncle(1 case),or multiple sites including the bulbar,palpebral and fomix conjunctiva(4 cases).The maximum lesion diameter ranged from 1.5 to 16.0 mm(mean,6.0±2.6 mm),with 59 cases measuring 5 to 10 mm.The duration of symptoms prior to diagnosis ranged from 0.5 to 20 years,with 52 cases having a disease course of 5 years or longer.Among the patients,59 had lesions without atypia,12 with mild atypia,and 4 with moderate to severe atypia.Pathological staging revealed 59 cases in stage Ⅰ A,14 in stage ⅠB,and 2 in stage Ⅱ.Conclusions:PAM primarily affects the bulbar conjunctiva and is predominantly a benign chronic condition.However,some cases exhibit atypia,and a small proportion may undergo malignant transformation.The degree of atypia and the extent of lesion are positively correlated with the risk of malignant progression in PAM.
primary acquired melanosismelanomaconjunctival melanocyte proliferative lesionsclinicopathological features
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