Melanocytic Nevus of the Superior Conjunctival Fornix: A Case Report

Abstract

Introduction: Conjunctival nevi are benign tumors that are commonly located at the nasal or temporal limbus and rarely in the fornix or tarsus. We report a case of a patient presenting with a solitary compound cystic nevus of the conjunctival fornix in the background of bilateral complexion-associated melanosis.

Case presentation: A 71-year-old African-American female was referred for evaluation of an incidentally noted melanocytic lesion of the right conjunctival fornix. The patient underwent an excisional biopsy, revealing histological features consistent with a compound cystic nevus.

Conclusion: This finding is noteworthy due to the rarity of conjunctival nevi originating in the fornix. The case underscores the importance of excisional biopsy in evaluating conjunctival forniceal melanocytic lesions to exclude malignant melanoma, a critical consideration for prognosis.

Keywords: Conjunctival lesion; Melanocytic nevus; Ocular oncology; Ocular surface.

Fig. 1.

Compound cystic nevus of superior conjunctival fornix. a Clinical photograph demonstrating the lesion involving the right superior palpebral conjunctiva and fornix. An adjacent pigmented elevated lesion involving the caruncle with surrounding melanosis is marked with an asterisk. b Clinical photograph with right upper eyelid eversion demonstrates the entire lesion. c Histologic examination revealed heavily pigmented melanocytes, mature nevus cells, and abundant melanin-laden macrophages in the underlying stroma, consistent with a pigmented cystic compound nevus of the conjunctiva. Multiple cysts were also present (hematoxylin and eosin, magnification, ×10). d Clinical photograph at last visit showing early symblepharon changes.