Clinical survey of 1643 melanocytic and nonmelanocytic conjunctival tumors.
OBJECTIVE
To report the spectrum and frequency of melanocytic and nonmelanocytic conjunctival tumors in an ocular oncology practice.


METHODS
Retrospective noninterventional case series.


METHODS
One thousand six hundred forty-three consecutive patients with a conjunctival mass evaluated at an ocular oncology department.


METHODS
A chart review was conducted to obtain the clinical features of the patient and tumor and to tabulate and categorize the diagnoses.


METHODS
Tumor diagnosis overall and relative to patient age, race, and gender and relative to tumor location and laterality.


RESULTS
In 1643 consecutive patients, the tumor was classified as melanocytic in 872 cases (53%) and nonmelanocytic in 771 cases (47%). The nonmelanocytic categories included congenital choristomatous (n = 40 [2%]), epithelial (n = 219 [13%]), vascular (n = 63 [4%]), fibrous (n = 7 [<1%]), neural (n = 1 [<1%]), xanthomatous (n = 1 [<1%]), myxomatous (n = 1 [<1%]), lipomatous (n = 23 [1%]), lacrimal gland origin (n = 12 [<1%]), lymphoid (n = 128 [8%]), leukemic (n = 3 [<1%]), metastatic (n = 13 [<1%]), secondary (n = 54 [3%]) tumors, and non-neoplastic lesions simulating a tumor (n = 206 [13%]). Of the 872 melanocytic lesions, the specific tumor diagnosis was nevus in 454 cases (52%), melanoma in 215 (25%), and primary acquired melanosis in 180 (21%). Patients with choristomatous, vascular, fibrous, xanthomatous, and myxomatous tumors presented at a mean age of <40 years, and those with malignant epithelial, lipomatous, leukemic, and secondary tumors presented at a mean age of >60. Of the 219 patients with epithelial tumors, 80% occurred in males, whereas the incidence of melanocytic lesions was equal in males and females. African-American patients represented only 7% of epithelial tumors, <1% of melanomas, and 8% of lymphoid tumors.


CONCLUSIONS
Conjunctival tumors were of melanocytic origin in 53% of cases and nonmelanocytic origin in 47%. Overall, melanocytic tumors, epithelial tumors, and lymphoid tumors accounted for 74% of all cases. These tumors were far more common in Caucasian patients, and epithelial tumors were found more frequently in men.
Shields
Carol L
CL
Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
Demirci
Hakan
H
Karatza
Ekaterina
E
Shields
Jerry A
JA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000145:classification / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D003230:Conjunctival Neoplasms / Q000145:classification / Q000473:pathology*; D005260:Female; D006801:Humans; D007223:Infant; D008223:Lymphoma / Q000145:classification / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009508:Nevus, Pigmented / Q000145:classification / Q000473:pathology*; D012189:Retrospective Studies; D017678:Sex Distribution