Conjunctival Squamous Cell Carcinoma with Corneal Stromal Invasion in Presumed Pterygia: A Case Series
| Autor: | Hans E. Grossniklaus, Matthew H. Ip, Caroline Craven, Minas T. Coroneo, Pia R. Mendoza, Matthew W. Wilson |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Pathology
medicine.medical_specialty Conjunctiva genetic structures medicine.medical_treatment Enucleation Brachytherapy Stromal Invasion 03 medical and health sciences 0302 clinical medicine Cornea medicine General Nursing Fluorometholone Conjunctival squamous cell carcinoma Original Paper business.industry medicine.disease eye diseases stomatognathic diseases medicine.anatomical_structure Dysplasia 030221 ophthalmology & optometry business 030217 neurology & neurosurgery medicine.drug |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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