Tag: conjunctival SCC

Invasive squamous cell carcinoma of conjunctiva looks like melanoma

In EnglishEN: Case of May 2016: patient presented with this brown elevated slowly-growing mass. Differential in our setup will always include OSSN. We know that conjunctival melanoma, uveal melanoma and skin melanoma are all quite rare in dark skinned people, though we consider it for differential as well (PMID 18191091). Histopathology confirmed invasive squamous cell carcinoma. It is hardly probable for OSSN to be black in white people. Nevertheless it is quite common in blacks.

Ideal treatment: wide excision with no-touch technique, followed by antimetabolites (5-FU/MMC) or cryotherapy. Lamellar sclerectomy is indicated when invasion is suspected. This case was managed without cryo. The technique for cryo is good described here:

Cryoprobe was placed on the lifted conjunctival margin for 3 seconds and then allowed to thaw. • A subsequent 3-second application would be applied adjacent to and slightly overlapping the prior application. Upon reaching the limbal margin, the cryoprobe was placed such that it would freeze the limbus and about 0.5mm of cornea.


in Russian / по-русскиRU: Инвазивный плоскоклеточный рак: чёрный маскарад. Случай от мая 2016 г.
Редкий случай чёрной поверхностной неоплазии глаза. В дифференциальный диагноз входила меланома, однако гистология подтвердила инвазивный плоскоклеточный рак. Довольно нетипичная пигментация, даже для чернокожих. Известно, что поверхностная неоплазия у белых людей практически не бывает пигментированной. В то же время, это не редкость среди людей с тёмной кожей. Полезный факт – всё глазные варианты меланомы – меланома кожи, сосудистой оболочки глаза и конъюнктивы глаза – встречаются значительно реже у чернокожих людей. Средняя по больнице заболеваемость конъюнктивальной меланомой – 0,012 на 100 тыс. населения (PMID 9763137). Но у чернокожих людей частота меланомы минимум в 3-4 раза меньше, чем у белых (PMID 18191091).

Invasive pigmented squamous cell carcinoma of conjunctiva. DDx: melanoma.

Invasive pigmented squamous cell carcinoma of conjunctiva. DDx: melanoma.

Bilateral advanced conjunctival squamous cell carcinoma

In EnglishThis patient’s case is unique: it is very rare to see conjunctival squamous cell carcinoma in both eyes at the same time, moreover it is rare to see them in advanced stage. This is a sad state of HIV patient with bilateral conjunctival squamous cell carcinoma. Left eye is in more advanced stage, and the cancer spreads in intraepithelial and papillomatous fasion to both upper, lower bulbar conjunctiva, upper tarsal conjunctiva and penetrates into cornea. Total orbital exenteration (involving the eyelids) is indicated for this eye. Right eye has a big protruding squamous cell carcinoma involving the limbus and third part of cornea infero-temporally. No obvious intraepithelial spread is seen upon examination of lower fornix and lateral/medial bulbar conjunctiva. Here, I opted to go for several stages of local chemoreduction (5-FU in 4 weekly cycles), and then will choose no-touch excision technique with cryo to the conjunctival margins +/- scleral bed. This eye is seeing comparatively well, and is amenable to the treatment at this stage, although with high chances for recurrence.

Bilateral conjunctival SCC