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SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyDrug Reaction DataReferences

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Melanoma - External and Internal Eye
See also in: Overview,Anogenital,Hair and Scalp,Oral Mucosal Lesion
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Melanoma - External and Internal Eye

See also in: Overview,Anogenital,Hair and Scalp,Oral Mucosal Lesion
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Contributors: Harvey A. Brown MD, Christopher Rapuano MD, Belinda Tan MD, PhD, Brandon D. Ayres MD, Sunir J. Garg MD, Lauren Patty Daskivich MD, MSHS, Susan Burgin MD
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Synopsis

Melanoma : Black color, Pigmented papule
Conjunctival melanoma are fairly rare occurrences, arising 0.2-0.8 per million in White individuals. They can arise de novo (approximately 10% of cases) from a preexisting nevus (20%) or from the flat spreading pigmentation of primary acquired melanosis with atypia (60%-70%). Primary malignant melanoma of the conjunctiva is not very common. It occurs predominantly in White individuals in their 50s and is rarely seen in Black individuals or children. In addition to spread by lymphatics and the bloodstream, direct extension to the eyeball and orbit occurs.

The overall tumor-related mortality rate for conjunctival melanoma is about 25%. This rate increases to about 40% if the tumor arises from primary acquired melanosis with an intraepithelial pagetoid growth pattern.

Iris melanomas are believed to arise from preexisting nevi. They are fairly uncommon, with an incidence of 1 per million per year. Light iris color is a risk factor. Sunlight exposure probably plays a role in their pathogenesis. They are not as aggressive as melanomas of the choroid and the ciliary body.

Codes

ICD10CM:
C43.9 – Malignant melanoma of skin, unspecified

SNOMEDCT:
372244006 – Malignant melanoma

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Conjunctival lesions:
Iris lesions:
  • Leiomyoma
  • Nevi
  • Iris cysts
  • Iridocorneal endothelial syndrome
  • Koeppe or Busacca nodules
  • Lisch nodules
  • Primary iris pigment epithelial tumors

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed:06/13/2022
Last Updated:06/14/2022
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Melanoma - External and Internal Eye
See also in: Overview,Anogenital,Hair and Scalp,Oral Mucosal Lesion
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A medical illustration showing key findings of Melanoma : Black color, Pigmented papule
Clinical image of Melanoma - imageId=732728. Click to open in gallery. caption: 'A close-up of a large variegated plaque with pink, dark brown, and rust colors. Note also irregular borders and asymmetry.'
A close-up of a large variegated plaque with pink, dark brown, and rust colors. Note also irregular borders and asymmetry.

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