case_images: PMC10869194_01
case_images: (a) Photoslit of the patient shows two separated lobulated nodular melanotic masses. (b) There is no clinical ocular surface, punctal, medial canthal, and caruncular involvement at the time of intranasal mass diagnosis. (c, d) Orbital and paranasal sinus MRI, coronal section, demonstrating intranasal moderately enhancing mass involving the right-sided nasal cavity and inferomedial part of the right orbit.
case_images: CRIOPM2024-1034939.001.jpg
case_images: PMC10869194_01_CRIOPM2024-1034939.001.jpg
case_images: fig1
case_images: Upon examination, two separate globular black-colored masses, each approximately 6 mm in diameter, were found at the 3 o'clock limbus (Figure 1(a)). They showed a mass-like lesion (lobulated moderately enhancing mass) involving the right-sided nasal cavity and inferomedial part of the right orbit (Figures 1(c) and 1(d)).
case_images: Representative photomicrographs of the presented case with conjunctival melanoma in the context of primary acquired melanosis with atypia (PAM). (a) The nodular proliferation of partially pigmented atypical melanocytes within the conjunctival stroma (N). (b) Nests of intraepithelial atypical melanocytes are highlighted (arrows), and scattered balloon cell transformations are also present. (c) Atypical melanocytes with severe nuclear pleomorphism (asterisk) and a few mitoses (arrows). (d) The presence of nests of atypical melanocytes in the limbal epithelium (arrow). (e (arrows), f) Scattered nests of atypical melanocytes are also present in the surrounding conjunctival epithelium, confirming the diagnosis of PAM.
case_images: CRIOPM2024-1034939.002.jpg
case_images: PMC10869194_01_CRIOPM2024-1034939.002.jpg
case_images: fig2
case_images: Nests of atypical melanocytes were also present in the surrounding conjunctival and limbal epithelia (Figure 2).