Primary basal cell carcinoma of the conjunctiva with. A possible role of uvb radiation is suggested by an excess of sccc in tropical countries and by the association between squamous cell skin cancer and exposure to uvb. Eight patients with conjunctival squamous cell carcinoma cscc were treated with topical 5fu fluorouracile roche, roche spa, milan, italy alone table 1. The patient was lost to followup and returned 2 months later with a rapidly enlarged lesion of the eyelid and anterior orbit, with radiographic evidence of orbital invasion. Biopsy revealed moderately differentiated squamous cell carcinoma with keratin pearls. Conjunctival squamous cell carcinoma conjuctival squamous cell carcinoma is a cancer on the surface of the eye and is usually found in older caucasian white skinned patients. Treatment of conjunctival squamous cell carcinoma with. The patient had limbal and corneal involvement temporally, as well as scleral invasion with intraocular spread. If these malignant appearing stratified squamous epithelial cells extend through the epithelial basement membrane and invade the substantia propria of the conjunctiva, it is characterized as invasive squamous cell carcinoma. Squamous cell carcinoma of the conjunctiva semantic scholar.
Ocular and periocular tumors in cats richard r dubielzig. Extensive conjunctival squamous cell carcinoma of the left eye. Ossn is a malignant disease of the eyes that can lead to loss of vision and, in severe cases, death. A black man aged 61 years with aids presented in our institution in 20 with extensive leftsided orbital soft tissue necrosis and exposure of deep orbital structures, with left eye le destruction caused by squamous cell carcinoma scc figure 1a. Anatomic distribution of feline primary ocular neoplasia n 2599 82 % 12. A patient with massive, protuberant squamous cell carcinoma of conjunctiva invading the whole cornea, so. Squamous cell carcinoma of the conjunctiva is thought to be an. Squamous eyelid carcinoma can have symptoms that range from the appearance of a hypervascular flat pale, reddish or flaky lesion on the eyelid skin to a thickened welldemarcated reddish, flat tumor surrounded by inflammation with or without scaling from its surface. The cornea is rarely the primary site for neoplasms, but it is frequently involved secondarily in conjunctival tumors such as squamous cell carcinoma and malignant melanoma. Magnetic resonance imaging with intravenous contrast enhancement did not show gross orbital involvement. A 59yearold man who had used an ocular prosthesis for 40 years had not removed the ocular prosthesis at all during the last 5 years. The general clinical term of ossn includes a spectrum of malignancies that ranges from mild epithelial dysplastic changes, such as conjunctival intraepithelial neoplasia cin, to more severe invasive carcinoma that invades through the basement membrane into the substantia propria, such as squamous cell carcinoma.
Squamous carcinoma of the eyelid new york eye cancer center. The main risk factors for both are exposure to solar ultraviolet radiation outdoors, hivaids, human. Methodsretrospective analysis of records from a tanzanian pathology department serving north and central tanzania from 1976 to 1997. Shields et al 12 recently reported a case series of 5 patients with intraocular invasion of conjunctival squamous cell carcinoma. The epidemiology of conjunctival squamous cell carcinoma. All books are in clear copy here, and all files are secure so dont worry about it. Two extremes of the clinical spectrum of conjunctival. Pdf to retrospectively study 26 patients with squamous cell carcinoma scc of the ocular surface to determine pathological and clinical. Introduction and epidemiology squamous cell carcinoma of the conjunctiva is the endstage of a spectrum of disease referred to as ocular surface squamous neoplasia ossn. Backgroundaims conjunctival squamous cell carcinoma cscc is the most frequent malignant tumour of the conjunctiva, with scarce recurrence and infrequent metastasis. T2weighted mri demonstrated total left orbital invasion. Feline conjunctival and lid squamous cell carcinoma severe lymphocytic inflammation.
Worldwide, conjunctival squamous cell carcinoma scc is an uncommon disease, the incidence of which varies geographically from 0. Ophthalmic surgery, lasers and imaging retina abstract. Conjunctival squamous cell carcinoma clinical atlas of. Conjunctival squamous cell carcinoma in tanzania europe. Conjunctival squamous cell carcinoma british journal of. Massive corneal and conjunctival squamous cell carcinoma.
Conjunctival squamous cell carcinoma and conjunctival. Conjunctival squamous cell carcinoma scc arising from an anophthalmic socket is quite rare, with few reports in the english literature. Clinical outcome of advanced squamous cell carcinoma. Rapidly progressive conjunctival squamous cell carcinoma. Pdf squamous cell carcinoma of the conjunctiva researchgate. To retrospectively study 26 patients with squamous cell carcinoma scc of the ocular surface to determine pathological and clinical characteristics of tumour associated with outcome. Conjunctival squamous cell carcinoma can be pigmented, similar to differentiation of pigmented conjunctival squamous cell carcinoma from melanoma ophthalmology. Atypia throughout full thickness of epithelium conjunctival intraepithelial neoplasia with individual tumor cells or nests extending into underlying stroma. Conjunctival congestion was present and corkscrewlike vascular loops were evident figure 2. A yearsold male tibetan patient known to have recurrent conjunctival squamous papilloma as well as dysplasia of the left eye for 2 years was eventually diagnosed with. Since this type more commonly extends beneath the conjunctival epithelium, nodular tumors exhibit increased metastatic potential. Conjunctival squamous cell carcinoma due to longterm. Treatment of conjunctival squamous cell carcinoma treatment options cases percentage excision alone 4 26. Conjunctival tumors range from benign to malignant and lifethreatening.
The most common type of nonmelanocytic tumors include ocular surface squamous neoplasia and lymphoma. Squamous cell carcinoma is a malignancy often arising in patients with longstanding histories of alcohol and tobacco use and associated comorbidities, whereas esophageal adenocarcinoma is. Hereditary factors, exposure to uv sunlight andor chronic inflammation may contribute to the development of conjunctival andor third eyelid tel scc. Clearcell squamous carcinoma, which usually occurs in the epidermis 1 but may occasionally be seen in mucous membranes, is less prone to metastasis than sebaceous carcinoma but has received virtually no attention in ophthalmology. The case of a 76 years old male patient with a conjunctival squamous cell carcinoma is presented. First described in 1976, conjunctival mucoepidermoid carcinoma is a rare and highly aggressive variant of conjunctival squamous cell carcinoma which can often require enucleation or orbital exenteration. The purpose of this study is to describe the clinical and pathological characteristics of this neoplasm and to identify the prognostic factors for recurrence and metastasis in a cancer hospital in peru. Conjunctival squamous cell carcinoma due to ocular prostheses. Methods eight patients affected by conjunctival squamous cell carcinoma three recurrent cases, three incompletely excised, and two untreated cases were treated with 1% 5fu eye drops. Aimto evaluate the efficacy of topical 5fluorouracil 5fu alone, without concurrent surgery or radiotherapy, for the treatment of conjunctival squamous cell carcinoma. Differentiation of pigmented conjunctival squamous cell. Tarek roshdy elhamakydepartment of ophthalmology, benha faculty of. Histopathology revealed conjunctival squamous dysplasia in 26%, carcinoma in situ in 39%, and squamous cell carcinoma in 36% of the patients.
As part of a larger investigation of cancer in uganda, we conducted a casecontrol study of conjunctival squamous cell carcinoma in adults presenting at hospitals in kampala. Methodseight patients affected by conjunctival squamous cell carcinoma three recurrent cases, three incompletely excised, and two untreated cases were treated with 1% 5fu eye drops. In summary, we report an advanced case of morpheaform basal cell carcinoma of the conjunctiva with intraocular spread and secondary glaucoma, which, to our knowledge, has not been reported. Conjunctival squamous cell carcinoma wills eye hospital. Aim to evaluate the efficacy of topical 5fluorouracil 5fu alone, without concurrent surgery or radiotherapy, for the treatment of conjunctival squamous cell carcinoma. Conjuctival squamous cell carcinoma is a cancer on the surface of the eye and is usually found in older caucasian white skinned patients. Cytopathological examination from incisional biopsy showed squamous cell carcinoma. Corneal involvement was found in 38% of 287 cases of conjunctival squamous cell neoplasia cin. Pdf conjunctival squamous cell carcinoma due to ocular. Diagnosis squamous carcinoma of the eyelid should be photographed at baseline. Squamous cell carcinoma of the conjunctiva is most common in caucasian individuals. The lesion was completely covering the corneal surface and involved the temporal limbus with bulbar conjunctiva. Treating squamous carcinomas of the conjunctiva and cornea.
Cancer of the conjunctiva squamous cell carcinoma of. Conjunctival cancer was associated with hiv infection or 10. She was referred to our hospital 5 months after the onset. The main clinical manifestation was discomfort, pain and redness in the eye. A case of recurrent squamous cell carcinoma of the conjunctiva is presented here. Squamous cell carcinoma of the conjunctiva is the endstage of a spectrum of disease referred to as ocular surface squamous neoplasia ossn. Squamous cell carcinoma scc of the conjunctiva is a rare malignancy. Patients with squamous cell carcinoma of the conjunctiva tend to be elderly, with an average age of 60 years.
Human papillomavirus type 16 also may be involved, given that it has been detected in benign and malignant conjunctival lesions and. A case of conjunctival mucoepidermoid carcinoma in australia. It appears as a white or yellowpink nodule on the eye surface in the front of the eye where it can easily be seen. Aimsto assess changes in incidence of conjunctival squamous cell carcinoma over a 22 year period in tanzania and to analyse possible reasons for change. There is also a nodular type that is circumscribed, rapidly growing, and invasive. Conjunctival squamous cell carcinoma, a rare entity.
He had a history of biopsyproven conjunctival scc in le, diagnosed in 2010. To report an extremely rare case of an extensive conjunctivalcorneal invasive squamous cell carcinoma. Characteristics, management, and outcome of squamous carcinoma. Backgroundaims conjunctival squamous cell carcinoma cscc is the most frequent malignant tumour of the conjunctiva, with scarce. Squamous cell carcinoma is the most frequently encountered malignant tumour of the conjunctiva. This cme activity will discuss the latest treatment approaches for conjunctival squamous cell carcinoma and conjunctival intraepithelial neoplasia. Asoct guided treatment of diffuse conjunctival squamous cell carcinoma with resection, amniotic membrane graft and topical mitomycin c tarek roshdy elhamaky, ahmed mohammed elbarky department of ophthalmology, benha faculty of medicine, benha university, benha, egyptcorrespondence.
Histo logic sections were stained with hematoxylineosin and van gieson. The cancer of the squamous epithelium was labeled as epithelioma by rudolph. Conjunctiva tumor an overview sciencedirect topics. Read online squamous cell carcinoma of conjunctiva. A consent statement, approved by the ethics committee, was signed by each patient. The purpose of this report is to present the findings in a case of squamous cell carcinoma scc of the conjunctiva which was the initial sign of systemic cancers. Squamous conjunctival carcinoma typically occurs on the bulbar conjunctiva, originating at the limbus, and often spreads onto the cornea. The cause of the clearcell change is unknown but not due to glycogen. Asoct guided treatment of diffuse conjunctival squamous. A case report of recurrent conjunctival squamous cell. Demographics, etiology, and behavior of conjunctival squamous. Pdf ocular surface squamous neoplasia is a term that describes neoplastic changes of the cornea and conjunctiva ranging from squamous.
Squamous carcinoma and intraepithelial neoplasia of the. This chapter presents the diagnosis and treatment for conjunctival squamous cell carcinoma scc, which occurs in the pug and the english bulldog. The etiology of squamous cell carcinoma of the conjunctiva sccc is not well known. Feline conjunctival melanoma 46 cases in the coplow database. This is believed to be due to occupational exposure to sunlight. Defined by abnormal malignant appearing epithelial cells replacing the entire conjunctival stratified squamous epithelial layer. A healthy 68yearold man referred to our department with a moderately elevated hyperemic nodular mass on his right ocular surface. Full text the full text of this article is available as a pdf 170k. A 94yearold woman without known systemic diseases developed a mass in her right conjunctiva. A case of squamous cell carcinoma of conjunctiva as. He had developed a mass on his entire right upper eyelid, and biopsy revealed a moderately differentiated scc. The main risk factors for both are exposure to solar ultraviolet radiation outdoors, hivaids, human papilloma virus and. Commonly, squamous conjunctival neoplasia will contain characteristic corkscrewshaped blood vessels. Squamous cell carcinoma is more common in males 75% than in females 25%.