Study: Conjunctival tumors in children rarely malignant

Issue: March 10, 2017

In a study of cases spanning nearly 40 years, only 3% of conjunctival tumors in children were malignant.

The retrospective case series analyzed the records of 782 patients with 806 conjunctival tumors. The patients were all younger than 21 years old and were evaluated at Wills Eye Center in Philadelphia between Nov. 1, 1975, and July 1, 2015.

In all, 779 of the tumors were benign and 27 were malignant. Of the malignant tumors, 18 were due to melanoma and nine to lymphoma.

Nonmalignant tumors were found at a mean age of 11 years, while malignant ones were detected at a mean age of 14 years (P = .005).

The two most common tumors found were nevus in 492 cases (61%) and benign reactive lymphoid hyperplasia (BRLH) in 38 cases (5%).

In comparing the features of melanoma vs. nevus, the authors found that 61% of melanoma cases had an onset in the age group between 15 years and 21 years; 29% of nevus cases had an onset in that age group.

A comparison between lymphoma and BRLH revealed 33% of lymphoma cases were located in an inferior quadrant, while 3% of BRLH cases were located there.

The authors wrote that limitations to the study include its retrospective nature.

“In addition, all diagnoses were made by ocular oncologists on the basis of clinical features, but not all were confirmed histopathologically because many benign conditions are managed with observation,” the authors said. “Furthermore, the number of patients with malignant tumors was small, so the power for comparison with the far more common benign conditions may not detect all clinical differences.” – by Joe Green

Disclosure : The authors report no relevant financial disclosures.

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Source:

Shields CL, et al. JAMA Ophthalmol. 2017;doi:10.1001/jamaophthalmol.2016.5544.