Melanocytic lesions of the conjunctiva: an up-to-date review

The conjunctiva is a thin mucous membrane covering the anterior portion of the eye. Similar to the skin, the conjunctiva has normal resident melanocytes along the basal layer of the epithelium and these cells can give rise to melanocytic neoplasms of the conjunctiva. A variety of pigmented tumors can involve the conjunctiva, ranging from benign to malignant. Given the sensitive anatomic location and potential for some conjunctival melanocytic lesions to progress to melanoma, timely clinical recognition and correct histologic diagnosis of these tumors are essential in order to initiate the appropriate treatment and optimize outcomes. Clinicopathologic correlation is a vital step in this process. In this review article, the authors aim to provide an up-to-date concise, yet detailed, summary of the clinical, histopathologic, and molecular findings as well as a brief mention of management options for each type of conjunctival melanocytic lesion that may be encountered by pathologists and dermatopathologists.