Conjunctival Squamous Cell Carcinoma with Corneal Stromal Invasion in Presumed Pterygia: A Case Series

Overview

Journal Ocul Oncol Pathol

Date 2019 Jan 16

PMID 30643769

Citations 6

Authors

Pia R Mendoza

Caroline M Craven

Matthew H Ip

Matthew W Wilson

Minas T Coroneo

Hans E Grossniklaus

Affiliations

Soon will be listed here.

Abstract

Aim: To describe 4 cases of conjunctival squamous cell carcinoma (SCC) with corneal stromal invasion.

Methods: Retrospective, clinicopathologic case series.

Results: All patients had prior resections of presumed pterygia. The degree of corneal involvement dictated the extent of surgical management. One eye with localized invasion was treated with lamellar keratoplasty and plaque brachytherapy. Another case with widespread invasion warranted penetrating keratoplasty and eventual enucleation. Two cases were treated medically prior to surgical intervention: one with localized invasion was treated with topical interferon and retinoic acid; another with significant inflammation was treated with doxycycline and fluorometholone. The patient who underwent keratoplasty and brachytherapy had no recurrence after 7 years of follow-up. Those initially treated medically had resections of recurrence but ultimately required enucleation. Histologically, specimens demonstrated SCC invading the deep corneal stroma, with 2 tumors of the mucoepidermoid type.

Conclusions: This series demonstrates the importance of maintaining clinical suspicion of conjunctival squamous neoplasia in pterygia. We recommend that all excised pterygia be submitted for histopathologic evaluation and be carefully evaluated for dysplasia and variants of SCC associated with increased risk of intraocular invasion. Undetected ocular surface squamous neoplasia may give rise to potentially vision- and eye-threatening invasive corneal SCC.

Citing Articles

Prevalence of co-existent neoplasia in clinically diagnosed pterygia in a UK population.

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Pterygium and Ocular Surface Squamous Neoplasia: Optical Biopsy Using a Novel Autofluorescence Multispectral Imaging Technique.

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Bergeron S, Ito H, Dossous Y, Burnier Jr M J Ophthalmol. 2021; 2021:6623794.

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Corneal melt in conjunctival intraepithelial neoplasia.

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