Multifocal amelanotic conjunctival melanoma

Clinical and histopathological features of four cases of multifocal amelanotic malignant melanoma of the conjunctiva in association with 'acquired melanosis sine pigmento' are reported. The absence ofconjunctival pigmentation in this extremely rare combination of lesions prevented early diagnosis and clinical monitoring. As a result orbital exenteration was required in three cases. This multicentric non-pigmented variety of conjunctival malignant melanoma tends to present later than pigmented forms and may require exenteration of the orbit as a primary procedure. ing in amelanotic acquired melanosis of the conjunctiva.' Griffith et all referred to the amelanotic precursor as 'acquired melanosis sine pigmento'. Jackobiec et all encountered a further four cases of multifocal conjunctival melanoma in association with amelanotic PAM, but did not mention the degree ofpigmentation ofthe malignant melanomas. We studied the clinical and histopathological features of four cases of multifocal amelanotic conjunctival melanoma arising in association with acquired melanosis sine pigmento.