Encyclopedia - Conjunctival Tumor

What are the types of conjunctival tumors?
How are conjunctival tumors treated?

Conjunctival tumors affect the clear, membrane-like tissue that covers the white of the eye -- the conjunctiva (See Anatomy of the Eye). Although these tumors are usually benign, they can occasionally be malignant and require immediate medical evaluation by an ophthalmologist.

Conjunctival tumors usually first appear as a spot or slightly raised area against the white background of the eye and are diagnosed by an eye doctor using a slit lamp. The only way to determine whether such a tumor is benign or malignant is to examine a portion of the tissue under a microscope. Although malignant tumors are seldom seen, they must be treated with either radiation or surgical removal.

Tumors that are malignant may have spread from another place in the body (metastasized). It is important to differentiate tumors that originated in or around the eye from those that have metastasized, because treatment options differ.

What are the types of conjunctival tumors?

Melanoma: The most common malignant tumor in the eye is a melanoma, which usually occurs in adults or mature patients. Conjunctival melanoma appears as a brown or pink nodule on the white surface of the eye and carries a 20 percent risk for metastasis. Early treatment, while the tumor is still small, is very important because, in about half of the cases, it can invade other parts of the eye requiring extensive surgery.

Nevus: A nevus is essentially a small, flat mole made up of specific cells called nevus cells that are found in the skin and in eye tissues. These types of tumors do not interfere with tissue function and seldom develop into a malignant melanoma.

Primary Acquired Melanosis: This is a flat, brown pigmentation on the surface of the eye that generally occurs in adults. It does carry some risk of developing into a malignant melanoma.

Squamous Cell Carcinoma: This is a type of cancer that can occur on any skin surface, including the eye, where it appears as a pink nodule on the eye surface. It is malignant and can invade around the eye into the orbit and sinuses.

Lymphoma: These tumors look like salmon-colored patches on the eye and can be a sign of systemic lymphoma. A biopsy is usually performed to determine if the tumor is benign or malignant. Patients with lymphoid conjunctival tumors should have a complete medical examination.

Cyst: A cyst is defined as any type of thin-walled sac, usually containing a liquid or semisolid. Such a tumor can be normal or abnormal depending on the cause.

Inflammatory tumor: A tumor that usually develops from the body's protective response to injury, infection, or irritation.

How are conjunctival tumors treated?

Conjunctival tumors are often diagnosed by examination with a slit-lamp biomicroscopy. If small, these tumors can be photographed and followed for evidence of growth prior to treatment. Most treatments focus on avoiding large surgeries which may be associated with vision loss or loss of the eye. If a tumor is diagnosed as nonmalignant, it may require only observation. If it is a vascular tumor, it may need laser treatment.

If the tumors are raised or extend onto the cornea, a biopsy may be required. Current treatments for conjunctival cancers include surgical removal, cryotherapy (freezing), radiation therapy, and more recently, chemotherapy eye-drops. These eye drops are in the investigational stage for patients with conjunctival tumors. The entire eye surface is treated, and this treatment may decrease the chance of future scarring. Standard chemotherapy is used to treat systemic lymphomas. If the eye is the only site of the lymphoma, external beam radiation therapy may be used.

Conjunctival tumors are serious and, if left untreated, can invade the tissues around the eye, the sinuses, and the brain. It is critical to obtain an early diagnosis and treatment for any eye cancer problem.