Blue Nevi of the Ocular Surface: Clinical Characteristics, Pathologic Features, and Clinical Course

Ibrahim Sayed-Ahmed, Juan Carlos Murillo, Pedro Monsalve, Jan Paul Ulloa, Maria P. Fernandez, James Wong, George Elgart, Anat Galor, Sander Dubovy, Carol Karp

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: Blue nevus is a melanocytic tumor that is commonly found in the skin. Extracutaneous presentations, including the ocular surface, are rare. As such, the purpose of this study was to characterize the clinical features and clinical course of congenital melanocytic tumor (blue nevus) of the conjunctiva. Design: Retrospective, noncomparative case series. Participants: Twenty-one patients with 23 blue nevi of the ocular surface that were excised surgically between 2000 and 2016. Methods: Chart review of patients identified from a database search of the Florida Lions Ocular Pathology Laboratory records. Pathologic diagnoses were confirmed by 2 pathologists (S.R.D. and G.E.). All specimens were bleached and, tissue permitting, stained using SOX10 (MilliporeSigma, Darmstadt, Germany) and CD68 (Leica Biosystems, Nussloch, Germany). Main Outcome Measures: Clinical characteristics, pathologic features, and clinical course. Results: Mean age of the population was 55±15 years; 71.4% (n = 15) were white and 57.1% (n = 12) were men. One patient had 3 lesions, for a total of 23 lesions examined. Clinically, 13 lesions were on the bulbar conjunctiva, 3 were on the tarsal conjunctiva, 3 were in the fornix, 2 were caruncular, 1 was episcleral, and 1 was at the limbus. Before excision, 8 patients were thought to have primary acquired melanosis, 4 with concern for primary conjunctival melanoma, and 1 thought to have metastatic disease from a plantar melanoma. Five lesions were thought to be benign, and in 8 patients, the lesions were identified incidentally after other ocular surgeries, with no diagnosis of the lesions before excision. Pathologic features were consistent with simple blue nevi in 21 lesions and cellular blue nevus in 2 lesions. No malignant transformations were noted in any patient over the mean 20.2-month follow-up period (range, 2 weeks–103 months). Conclusions: Blue nevus is a rare deeply pigmented congenital melanocytic lesion with a benign clinical course that can appear clinically similar to primary acquired melanosis or melanoma.

Original languageEnglish (US)
JournalOphthalmology
DOIs
StateAccepted/In press - Jan 1 2018

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Blue Nevus
Conjunctiva
Melanosis
Melanoma
Germany
Lions
Neoplasms
Outcome Assessment (Health Care)
Databases
Pathology
Skin
Population

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Blue Nevi of the Ocular Surface : Clinical Characteristics, Pathologic Features, and Clinical Course. / Sayed-Ahmed, Ibrahim; Murillo, Juan Carlos; Monsalve, Pedro; Ulloa, Jan Paul; Fernandez, Maria P.; Wong, James; Elgart, George; Galor, Anat; Dubovy, Sander; Karp, Carol.

In: Ophthalmology, 01.01.2018.

Research output: Contribution to journalArticle

Sayed-Ahmed, Ibrahim ; Murillo, Juan Carlos ; Monsalve, Pedro ; Ulloa, Jan Paul ; Fernandez, Maria P. ; Wong, James ; Elgart, George ; Galor, Anat ; Dubovy, Sander ; Karp, Carol. / Blue Nevi of the Ocular Surface : Clinical Characteristics, Pathologic Features, and Clinical Course. In: Ophthalmology. 2018.
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abstract = "Purpose: Blue nevus is a melanocytic tumor that is commonly found in the skin. Extracutaneous presentations, including the ocular surface, are rare. As such, the purpose of this study was to characterize the clinical features and clinical course of congenital melanocytic tumor (blue nevus) of the conjunctiva. Design: Retrospective, noncomparative case series. Participants: Twenty-one patients with 23 blue nevi of the ocular surface that were excised surgically between 2000 and 2016. Methods: Chart review of patients identified from a database search of the Florida Lions Ocular Pathology Laboratory records. Pathologic diagnoses were confirmed by 2 pathologists (S.R.D. and G.E.). All specimens were bleached and, tissue permitting, stained using SOX10 (MilliporeSigma, Darmstadt, Germany) and CD68 (Leica Biosystems, Nussloch, Germany). Main Outcome Measures: Clinical characteristics, pathologic features, and clinical course. Results: Mean age of the population was 55±15 years; 71.4{\%} (n = 15) were white and 57.1{\%} (n = 12) were men. One patient had 3 lesions, for a total of 23 lesions examined. Clinically, 13 lesions were on the bulbar conjunctiva, 3 were on the tarsal conjunctiva, 3 were in the fornix, 2 were caruncular, 1 was episcleral, and 1 was at the limbus. Before excision, 8 patients were thought to have primary acquired melanosis, 4 with concern for primary conjunctival melanoma, and 1 thought to have metastatic disease from a plantar melanoma. Five lesions were thought to be benign, and in 8 patients, the lesions were identified incidentally after other ocular surgeries, with no diagnosis of the lesions before excision. Pathologic features were consistent with simple blue nevi in 21 lesions and cellular blue nevus in 2 lesions. No malignant transformations were noted in any patient over the mean 20.2-month follow-up period (range, 2 weeks–103 months). Conclusions: Blue nevus is a rare deeply pigmented congenital melanocytic lesion with a benign clinical course that can appear clinically similar to primary acquired melanosis or melanoma.",
author = "Ibrahim Sayed-Ahmed and Murillo, {Juan Carlos} and Pedro Monsalve and Ulloa, {Jan Paul} and Fernandez, {Maria P.} and James Wong and George Elgart and Anat Galor and Sander Dubovy and Carol Karp",
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T2 - Clinical Characteristics, Pathologic Features, and Clinical Course

AU - Sayed-Ahmed, Ibrahim

AU - Murillo, Juan Carlos

AU - Monsalve, Pedro

AU - Ulloa, Jan Paul

AU - Fernandez, Maria P.

AU - Wong, James

AU - Elgart, George

AU - Galor, Anat

AU - Dubovy, Sander

AU - Karp, Carol

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Purpose: Blue nevus is a melanocytic tumor that is commonly found in the skin. Extracutaneous presentations, including the ocular surface, are rare. As such, the purpose of this study was to characterize the clinical features and clinical course of congenital melanocytic tumor (blue nevus) of the conjunctiva. Design: Retrospective, noncomparative case series. Participants: Twenty-one patients with 23 blue nevi of the ocular surface that were excised surgically between 2000 and 2016. Methods: Chart review of patients identified from a database search of the Florida Lions Ocular Pathology Laboratory records. Pathologic diagnoses were confirmed by 2 pathologists (S.R.D. and G.E.). All specimens were bleached and, tissue permitting, stained using SOX10 (MilliporeSigma, Darmstadt, Germany) and CD68 (Leica Biosystems, Nussloch, Germany). Main Outcome Measures: Clinical characteristics, pathologic features, and clinical course. Results: Mean age of the population was 55±15 years; 71.4% (n = 15) were white and 57.1% (n = 12) were men. One patient had 3 lesions, for a total of 23 lesions examined. Clinically, 13 lesions were on the bulbar conjunctiva, 3 were on the tarsal conjunctiva, 3 were in the fornix, 2 were caruncular, 1 was episcleral, and 1 was at the limbus. Before excision, 8 patients were thought to have primary acquired melanosis, 4 with concern for primary conjunctival melanoma, and 1 thought to have metastatic disease from a plantar melanoma. Five lesions were thought to be benign, and in 8 patients, the lesions were identified incidentally after other ocular surgeries, with no diagnosis of the lesions before excision. Pathologic features were consistent with simple blue nevi in 21 lesions and cellular blue nevus in 2 lesions. No malignant transformations were noted in any patient over the mean 20.2-month follow-up period (range, 2 weeks–103 months). Conclusions: Blue nevus is a rare deeply pigmented congenital melanocytic lesion with a benign clinical course that can appear clinically similar to primary acquired melanosis or melanoma.

AB - Purpose: Blue nevus is a melanocytic tumor that is commonly found in the skin. Extracutaneous presentations, including the ocular surface, are rare. As such, the purpose of this study was to characterize the clinical features and clinical course of congenital melanocytic tumor (blue nevus) of the conjunctiva. Design: Retrospective, noncomparative case series. Participants: Twenty-one patients with 23 blue nevi of the ocular surface that were excised surgically between 2000 and 2016. Methods: Chart review of patients identified from a database search of the Florida Lions Ocular Pathology Laboratory records. Pathologic diagnoses were confirmed by 2 pathologists (S.R.D. and G.E.). All specimens were bleached and, tissue permitting, stained using SOX10 (MilliporeSigma, Darmstadt, Germany) and CD68 (Leica Biosystems, Nussloch, Germany). Main Outcome Measures: Clinical characteristics, pathologic features, and clinical course. Results: Mean age of the population was 55±15 years; 71.4% (n = 15) were white and 57.1% (n = 12) were men. One patient had 3 lesions, for a total of 23 lesions examined. Clinically, 13 lesions were on the bulbar conjunctiva, 3 were on the tarsal conjunctiva, 3 were in the fornix, 2 were caruncular, 1 was episcleral, and 1 was at the limbus. Before excision, 8 patients were thought to have primary acquired melanosis, 4 with concern for primary conjunctival melanoma, and 1 thought to have metastatic disease from a plantar melanoma. Five lesions were thought to be benign, and in 8 patients, the lesions were identified incidentally after other ocular surgeries, with no diagnosis of the lesions before excision. Pathologic features were consistent with simple blue nevi in 21 lesions and cellular blue nevus in 2 lesions. No malignant transformations were noted in any patient over the mean 20.2-month follow-up period (range, 2 weeks–103 months). Conclusions: Blue nevus is a rare deeply pigmented congenital melanocytic lesion with a benign clinical course that can appear clinically similar to primary acquired melanosis or melanoma.

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