Download PDF

Make your diagnosis in the comments, and look for the answer in next month’s Blink.

Last Month’s Blink

Giant Conjunctival Melanoma

Written by Carlos E. Chacon, MD, and Alexander Rabinovich, MD. Photo by Sergio Alfonso Garces Uribe, MD. All are at Maracaibo University Hospital, Zulia, Venezuela.

A 24-year-old woman presented with a rapidly growing, painless, pigmented lesion of the conjunctiva (Fig. 1). Physical examination showed a mobile, dark brown lesion in the temporal conjunctiva near the corneal limbus (Figs. 2-3) that compromised palpebral closure. Ultrasound biomicroscopy was performed to obtain approximate measurements of the lesion and to determine its exact location for diagnostic and management considerations (Fig. 4). Diagnosis of giant conjunctival melanoma was made via excisional biopsy, and the patient was referred to the ocular oncology service.

The differential diagnosis of this perilimbal lesion includes a large nevus and melanoma of the ciliary body with extraocular extension.

Read your colleagues’ discussion.