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Conjunctival Mascaroma Masquerading as Melanoma

Shields, Jerry A MD*; Marr, Brian P MD*; Shields, Carol L MD*; Eagle, Ralph C Jr MD†

Case Reports

Purpose: To describe a conjunctival mass composed of keratin with mascara deposition that clinically simulated a melanoma.

Methods: A 50-year-old woman, who used mascara for 20 years, was referred for a conjunctival mass that was suspected to be melanoma. Excisional biopsy was performed, and the lesion was studied histopathologically.

Results: The lesion consisted of conjunctival epithelium with a keratin plaque that contained multiple dark particles that exhibited birefringence with polarized light. The final diagnosis was conjunctival hyperkeratosis containing foreign bodies compatible with mascara deposition. The patient continues to use mascara, and there is no recurrence after 12 months.

Conclusions: Deposition of mascara can assume tumorous proportions and simulate a conjunctival melanoma.

From the *Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA; and the †Department of Pathology, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA.

Received for publication April 29, 2004; accepted June 22, 2004.

Supported by the Eye Tumor Research Foundation, Philadelphia, PA, by the Award of Merit in Retina Research, Houston, TX (Dr. J. Shields), by the Macula Foundation, New York, NY (Dr. C. Shields), and by the Noel T. and Sara L. Simmonds Endowment for Ophthalmic Pathology, Wills Eye Hospital, Philadelphia, PA (Dr. Eagle).

Reprints: Jerry A. Shields, MD, Ocular Oncology Service, Wills Eye Hospital, 840 Walnut Street, Philadelphia, PA 19107 (e-mail: jerry.shields@shieldsoncology.com).

© 2005 Lippincott Williams & Wilkins, Inc.