Answer
A primary tumor (T) is classified as follows:
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TX - Primary tumor cannot be assessed
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TO - No evidence of primary tumor
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T1 - Tumor(s) of bulbar conjunctiva occupying 1 quadrant or less
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T2 - Tumor(s) of bulbar conjunctiva occupying more than 1 quadrant
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T3 - Tumor(s) of conjunctival fornix and/or palpebral conjunctiva and/or caruncle
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T4 - Tumor invades eyelid, cornea, and/or orbit
An aggressive conjunctival melanoma with lid involvement. Courtesy of Peter Rubin, MD, Director, Eye Plastics Service, Massachusetts Eye & Ear Infirmary, Boston, MA.
Large conjunctival melanoma that has invaded the orbit. Courtesy of Peter Rubin, MD, Director, Eye Plastics Service, Massachusetts Eye & Ear Infirmary, Boston, MA.
Regional lymph nodes (N) are classified as follows:
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NX - Regional lymph nodes cannot be assessed
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N0 - No regional lymph node metastasis
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N0a - No regional lymph node metastasis, biopsy performed
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N0b - No regional lymph node metastasis, biopsy not performed
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N1 - Regional lymph node metastasis
Distant metastasis (M) is classified as follows:
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MX - Distant metastasis cannot be assessed
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M0 - No distant metastasis
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M1 - Distant metastasis
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Conjunctival melanomas may be associated with primary acquired melanosis (75%) or may arise from a preexisting nevus or de novo. Reprinted from University of Utah, Peter DeBry, Kwok Li, and Nick Mamalis, MD, Ophthalmic Pathology: An Internet Ocular Pathology Archive, with permission from University of Utah Ophthalmic Pathology.
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Dysplastic melanocytes may invade beyond the epithelium into the substantia propria or into the globe or lids. Reprinted from University of Utah, Peter DeBry, Kwok Li, and Nick Mamalis, MD, Ophthalmic Pathology: An Internet Ocular Pathology Archive, with permission from University of Utah Ophthalmic Pathology.
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Conjunctival melanoma. Courtesy of Peter Rubin, MD, Director, Eye Plastics Service, Massachusetts Eye & Ear Infirmary, Boston, MA.
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Conjunctival melanoma. Courtesy of Peter Rubin, MD, Director, Eye Plastics Service, Massachusetts Eye & Ear Infirmary, Boston, MA.
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Tarsal conjunctival melanoma. Courtesy of Peter Rubin, MD, Director, Eye Plastics Service, Massachusetts Eye & Ear Infirmary, Boston, MA.
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Conjunctival nevus. Courtesy of Peter Rubin, MD, Director, Eye Plastics Service, Massachusetts Eye & Ear Infirmary, Boston, MA.
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An aggressive conjunctival melanoma with lid involvement. Courtesy of Peter Rubin, MD, Director, Eye Plastics Service, Massachusetts Eye & Ear Infirmary, Boston, MA.
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Large conjunctival melanoma that has invaded the orbit. Courtesy of Peter Rubin, MD, Director, Eye Plastics Service, Massachusetts Eye & Ear Infirmary, Boston, MA.
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Histologic findings of invasive melanoma cells may be small polyhedral, epithelioid, spindled, or ballooned. Courtesy of Peter Rubin, MD, Director, Eye Plastics Service, Massachusetts Eye & Ear Infirmary, Boston, MA.
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Conjunctival melanomas. Courtesy of Peter Rubin, MD, Director, Eye Plastics Service, Massachusetts Eye & Ear Infirmary, Boston, MA.
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Invasive conjunctival melanoma. Courtesy of Peter Rubin, MD, Director, Eye Plastics Service, Massachusetts Eye & Ear Infirmary, Boston, MA.
