Clinical Features and Histopathological Classifications of 305 Conjunctival Tumors Surgically Treated in a Single Institution Study with Particular Regard to Pigmentation and Interview Data

Purpose
Retrospective clinical and histopathological analysis of conjunctival lesions surgically treated during one year in our institution in correlation with the interview data, with special regard to the practical approach through the division into pigmented and amelanotic lesion with setting the probability of their attribution to benign, pre-neoplasmatic and malignant ones.

Material and methods
305 patients (164 men, 141 women) who underwent surgical excision of conjunctival tumors in 2017 at  the Department of Ophthalmology and Ocular Oncology Jagiellonian University Medical College in Krakow were analyzed. Color photographs of lesions and the histopathological result were evaluated.

Results
Conjunctival tumors pigmented clinically were noted in 190 (62.3%) cases, and tumors without pigment in 115 (37.7%). Histopathological examination confirmed the presence of benign lesions in 153 (80.5%) in the first group and 62 (53.9%) in the second. Primary changes were found in 264 (86.6%) patients. In 6 (2.0%) cases the infiltration occurred at the scar site after other surgical procedures. The remaining 35 (11.4%) cases were a local recurrence after previous conjunctival tumor resection. The recurrence tendency was most frequently characterized by tumors described in histopathology as melanocytic cancerous and precancerous. Lesions that have increased significantly in the last weeks and months before excision and observed less than a year more often showed malignant or precancerous nature. In patients with malignant conjunctival tumors, malignancies of other organs were more common (18.5%) than in patients with benign and pre-cancerous lesions (6.5%).

Conclusions
In the case of conjunctival tumors, both the clinical examination and the patient痴 history carefully collected can be helpful in the establishing the appropriate, initial diagnosis and making optimal therapeutic decisions.