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

Pia R. Mendoza, Caroline M. Craven, Matthew H. Ip, Matthew Wilson, Minas T. Coroneo, Hans E. Grossniklaus

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)240-249
Number of pages10
JournalOcular Oncology and Pathology
Volume4
Issue number4
DOIs
StatePublished - Jun 1 2018

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Pterygium
Squamous Cell Carcinoma
Corneal Transplantation
Brachytherapy
Fluorometholone
Mucoepidermoid Tumor
Corneal Stroma
Recurrence
Penetrating Keratoplasty
Doxycycline
Tretinoin
Interferons
Neoplasms
Inflammation

All Science Journal Classification (ASJC) codes

  • Nursing(all)

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Conjunctival Squamous Cell Carcinoma with Corneal Stromal Invasion in Presumed Pterygia : A Case Series. / Mendoza, Pia R.; Craven, Caroline M.; Ip, Matthew H.; Wilson, Matthew; Coroneo, Minas T.; Grossniklaus, Hans E.

In: Ocular Oncology and Pathology, Vol. 4, No. 4, 01.06.2018, p. 240-249.

Research output: Contribution to journalArticle

Mendoza, Pia R. ; Craven, Caroline M. ; Ip, Matthew H. ; Wilson, Matthew ; Coroneo, Minas T. ; Grossniklaus, Hans E. / Conjunctival Squamous Cell Carcinoma with Corneal Stromal Invasion in Presumed Pterygia : A Case Series. In: Ocular Oncology and Pathology. 2018 ; Vol. 4, No. 4. pp. 240-249.
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