When narrative medicine helps in the diagnosis of conjunctival melanoma - an exceptional case report.
BACKGROUND
Conjunctival melanoma is a relatively rare ocular malignancy with substantial associated morbidity and mortality. It can arise in previously unblemished and unpigmented regions (approximately 10% of cases), from a preexisting nevus (approximately 20% of cases), or from the flat, spreading pigmentation of primary acquired melanosis with atypia (60-70% of cases), actually called conjunctival melanocytic intraepithelial neoplasia (C-MIN) with atypia (histopathologically more accurately term).


OBJECTIVE
The authors describe an extremely rare case of malignant conjunctival melanoma, with a long evolution, in a young black woman.


RESULTS
Until now the patient has not shown any sign of relapse of this melanoma, after local excision.


CONCLUSIONS
Conjunctival melanoma is a condition of concern because of its rarity and lethal potential. Advances in the understanding and management of this neoplasm have markedly reduced the mortality and possibly the morbidity associated with this malignancy. We observe that there are some cases of conjunctival melanoma that might be cured with only a local excision with posterior cryotherapy without more aggressive methods. The practice of narrative medicine brings new possibilities in the diagnosis and collection of classical history.
Ophthalmology Department, Centro Hospitalar Lisboa Norte/Hospital Santa Maria, Lisboa, Portugal.
Ana Teresa
AT
Nunes
Ophthalmology Department, Centro Hospitalar Lisboa Norte/Hospital Santa Maria, Lisboa, Portugal.
Leonor
L
Almeida
Pathology Department, Centro Hospitalar Lisboa Norte/Hospital Santa Maria, Lisboa, Portugal.
Conceição
C
Crujo
Ophthalmology Department, Centro Hospitalar Lisboa Norte/Hospital Santa Maria, Lisboa, Portugal.
Manuel
M
Monteiro-Grillo
conjunctival melanoma; narrative medicine; oncology; treatment