title: Hughes technique, amniotic membrane allograft, and topical chemotherapy in conjunctival melanoma with eyelid involvement.
abstract: A 59-year-old woman presented with a pigmented mass in the inferior tarsal conjunctiva of the left eye with an associated diffuse, multifocal pigmentation involving largely the inferior half of the bulbar conjunctiva, fornix, and eyelid skin. Histopathologic examination of map biopsies disclosed conjunctival melanoma from primary acquired melanosis. Surgical excision of the inferior bulbar conjunctiva, fornix, and lower eyelid with histopathologic free margins was performed. Adjuvant cryotherapy was applied. The bulbar conjunctiva and lower fornix were reconstructed with an amniotic membrane allograft. Lower eyelid reconstruction was accomplished by use of the Hughes technique. Topical mitomycin C (0.04%) was applied after surgery. After 2 years of follow-up, no tumor recurrence has been detected and the eyelid and conjunctival defect have been satisfactorily corrected. This combined surgical procedure using amniotic membrane allograft and a composite tarsoconjunctival flap is shown to be useful in the treatment of an advanced conjunctival neoplasia with extensive eyelid involvement.
authors.affiliation: Ocular Oncology and Oculoplastics Unit, Instituto Universitario de Oftalmobiología Aplicada (IOBA), Valladolid, Spain.
authors.forename: Emiliano M
authors.initials: EM
authors.lastname: Becerra
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Blanco
authors.forename: Maria A
authors.initials: MA
authors.lastname: Saornil
authors.forename: Maria
authors.initials: M
authors.lastname: del C Méndez
authors.forename: Carlos G
authors.initials: CG
authors.lastname: Bianciotto
mesh_terms: D000287:Administration, Topical; D000650:Amnion / Q000637:transplantation*; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003230:Conjunctival Neoplasms / Q000601:surgery*; D005142:Eyelid Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008545:Melanoma / Q000601:surgery*; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D013508:Ophthalmologic Surgical Procedures; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps; D014184:Transplantation, Homologous
chemical_list: D000903:Antibiotics, Antineoplastic; D016685:Mitomycin