All patients showed excellent evolution without recurrence. Treatment of conjunctival squamous cell carcinoma treatment options cases percentage excision alone 4 26. 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. Incidence of squamouscell carcinoma of the conjunctiva and other. Characteristics, management, and outcome of squamous carcinoma. There is also a nodular type that is circumscribed, rapidly growing, and invasive. Hpv type 16 in conjunctival and junctional papilloma, dysplasia, and squamous cell carcinoma.
Abstract background the term ocular surface squamous neoplasia ossn. Treating squamous carcinomas of the conjunctiva and cornea. However, it is difficult to determine the grading of dysplasia by clinical morphologic findings. Conjunctival squamous cell carcinoma wills eye hospital. The conjunctival epithelium merges into the nonkeratinized stratified. Conjunctival intraepithelial neoplasia cin is non invasive by definition. Sep 19, 2016 conjunctival tumors range from benign to malignant and lifethreatening.
Corneal and conjunctival intraepithelial neoplasia a case. Ocular surface squamous neoplasia was first described by lee and hirst in 1995 as an umbrella term that encompasses both intraepithelial and invasive squamous cell carcinoma namely, carcinoma. Histologically, squamous carcinomas which arise in the conjunctival epithelium are well differentiated tumors. Conjunctival intraepithelial neoplasia and scc are histopathologically welldefined conditions. When carcinoma is confined to the epithelium, it is called corneal conjunctival intraepithelial neoplasia or carcinoma in situ or squamous intraepithelial neoplasia. 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. Keratoacanthoma of the conjunctiva in a young patient scielo. Patient oe, a 90yearold female, was admitted for a tumor mass in the bulbar conjunctiva of the right eye, which was painless, and displacing the eyeball inferotemporally. Defined by abnormal malignant appearing epithelial cells replacing the entire conjunctival stratified squamous epithelial layer. Sometimes, many nodes might be removed in a more extensive operation called a. The tumor was excised with a safety margin to exclude squamous cell. After a mean follow up of 56 months 18226 months the rate of new or recurrent tumours was 4. Cancer of the conjunctiva squamous cell carcinoma of the. Conjunctival squamous cell carcinomas sccs are rare neoplasms.
Seen in age from 1860 years with the majority between 20 and 40 years. Squamous cell carcinoma is locally invasive but rarely spreads to distant sites. Ossn is a malignant disease of the eyes that can lead to loss of vision and, in severe cases, death. Pdf to retrospectively study 26 patients with squamous cell carcinoma scc of the ocular surface to determine pathological and clinical. Images a and b show moderately differentiated squamous cell carcinoma, with deep royal blue staining.
A 94yearold woman without known systemic diseases developed a mass in her right conjunctiva. Atypia throughout full thickness of epithelium conjunctival intraepithelial neoplasia with individual tumor cells. It may develop from a papilloma, leukoplakia, intraepithelial epithelioma bowen disease, or spontaneous metaplasia. Ossn includes conjunctival andor corneal intraepithelial neoplasia, intraepithelial carcinoma of the. Worldwide, conjunctival squamous cell carcinoma scc is an uncommon disease, the incidence of which varies geographically from 0.
Ocular surface squamous neoplasia ossn encompasses a broad spectrum of neoplastic squamous abnormalities of the conjunctival, limbal. We report a case of a 24yearold man with a rapidly growing conjunctival mass. In situ carcinoma of the conjunctiva may be simply and successfully treated with surgical excision and cryotherapy. Scc is the most common malignancy of the conjunctiva in the us, with a yearly incidence of 12. Conjunctival squamous cell carcinoma with corneal stromal. Cutaneous squamous cell carcinoma diagnosis pathology abstract cutaneous squamous cell carcinoma cscc is one of the most common cancers in caucasian populations, accounting for 20% of all cutaneous malignancies. Squamous carcinoma and intraepithelial neoplasia of the. The treatment of squamous cell carcinoma scc of the conjunctiva is complicated by high recurrence rates, damage to adjacent ocular structures, or both, in cases where more invasive interventions are required.
The cytomorphology of ocular surface squamous neoplasia by using. Squamous cell carcinoma is more common in males 75% than in females 25%. Community eye health journal squamous cell carcinoma of the. A number of cases of canine primary scc of the cornea have been described especially in recent years 5 10, and some authors report an increased occurrence of the tumor in. This is believed to be due to occupational exposure to sunlight. Treatment of conjunctival squamous neoplasias with interferon. Basal and squamous cell skin cancer causes, risk factors, and. Ultraviolet light uv exposure, especially in individuals with light skin pigmentation, is a known risk factor for ossn, and the prevalence of ossn is higher in equatorial regions of the world. If untreated for an extensive period of time, the tumor can invade into the sclera, anterior chamber, andor orbit. Ocular surface squamous neoplasia go to academy store learn more and purchase. Abstract objective to determine modifiable risk factors of ocular surface squamous neoplasia ossn in.
This cme activity will discuss the latest treatment approaches for conjunctival squamous cell carcinoma and conjunctival intraepithelial neoplasia. Sep 15, 2016 cin is an abnormal line of conjunctival and possibly corneal epithelial cells and represents either simple dysplasia partial thickness of epithelial tissue or carcinoma in situ when the lesion is full thickness. Conjunctival lesions before and after staining with 0. To investigate the risk factors for squamouscell carcinoma of the. It is a slow growing tumor that arises from a single mutated cell on the ocular surface.
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. Aggressive conjunctival squamous cell carcinoma in a patient. Pdf the epidemiology of conjunctival squamous cell. Topical mitomycin c for partially excised ocular surface squamous. Risk factors for the disease are exposure to sun specifically occupational, exposure to uvb, and lightcolored skin. Only very large squamous conjunctival cancers and those in patients who are immunosuppressed metastasize to other parts of the body. Histopathology revealed conjunctival squamous dysplasia in 26%, carcinoma in situ in 39%, and squamous cell carcinoma in 36% of the patients. Often the squamous cell carcinoma of the conjunctival may be. Diagnosis and treatment of invasive squamous cell carcinoma. See also spindle cell carcinoma, mucoepidermoid carcinoma.
A unique collaboration of multidisciplinary experts from the european dermatology forum edf, the. Clinical outcome of advanced squamous cell carcinoma of the. When it spreads into the deeper tissues, it is known as invasive squamous cell carcinoma. Conjunctival squamous cell carcinoma is a cancer on the surface of the eye. Squamous carcinoma of the conjunctiva can form a nodule or diffusely spread out over the surface of the eye. Commonly, squamous conjunctival neoplasia will contain characteristic corkscrewshaped blood vessels. Shields et al 12 recently reported a case series of 5 patients with intraocular invasion of conjunctival squamous cell carcinoma. She was referred to our hospital 5 months after the onset. If lymph nodes near a squamous or basal cell skin cancer are enlarged, the doctor might biopsy them to check for cancer cells see tests for basal and squamous cell skin cancer2. It usually arises at the limbus as papillary exophytic greywhite mass. Primary basal cell carcinoma of the conjunctiva with. Combining with clinical features a diagnosis of invasive scc was given. Possible prognostic markers in conjunctival dysplasia and.
Squamous cell neoplasia of the ocular surface can occur as a localized lesion confined to the surface epithelium conjunctival intraepithelial neoplasia or dysplasia, currently called cin, or as a more invasive squamous cell carcinoma that has broken through the basement membrane and invaded the underlying stroma. Conjunctival squamous cell carcinoma and conjunctival. Invasive squamous cell carcinoma of the conjunctiva. This study deals with the likelihood of intraocular invasion by conjunctival squamous cell carcinoma which is uncommon. Treatment of conjunctival papillomata with topical interferon alfa2b. The most common type of nonmelanocytic tumors include ocular surface squamous neoplasia and lymphoma. However rather than combining recurrence results as a whole under ossn category, it is better to. Ocular surface squamous neoplasia ossn is a spectrum of conjunctival diseases that. Squamous cell carcinoma of the conjunctiva most commonly spreads superficially, extending into the conjunctival stroma and corneal epithelium. But they can invade into and around the eye, into the orbit and sinuses. Cin is known by other names including bowens disease, conjunctival squamous dysplasia. Pdf invasive squamous cell carcinoma of the conjunctiva. The epidemiology of conjunctival squamous cell carcinoma in uganda article pdf available in british journal of cancer 873.
Learn more about the risk factors for basal and squamous cell skin cancer. Pdf squamous cell carcinoma of the conjunctiva researchgate. Clinical outcome of advanced squamous cell carcinoma of. The main risk factors for both are exposure to solar ultraviolet radiation outdoors, hivaids, human. Risk factors for ocular surface squamous neoplasia in kenya. Squamous cell carcinoma scc of the conjunctiva is a rare malignancy.
Conjunctival squamous cell carcinoma conjunctival scc and corneal intraepithelial neoplasia comprise what are called ocular surface squamous cell neoplasias. Basal and squamous cell skin cancer causes, risk factors, and prevention cancer. 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. Jun 14, 2019 saegusa m, takano y, hashimura m, et al. It appears as a white or yellowpink nodule on the eye surface in the front of the eye where it can easily be seen. 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. Squamous cell carcinoma of the conjunctiva is most common in caucasian individuals. Wide excision, cryotherapy, amniotic membrane transplant can. Since this type more commonly extends beneath the conjunctival epithelium, nodular tumors exhibit increased metastatic potential. Rare but more common than basal cell carcinoma at this site in us, precancerous lesions are excised, so invasive carcinoma is uncommon rates.
Ocular surface squamous neoplasia ossn is a dysplasia of the conjunctival, limbal, or corneal epithelium,1 with a prevalence of 0. Patients with squamous cell carcinoma of the conjunctiva tend to be elderly, with an average age of 60 years. Conjunctival squamous cell carcinoma scc can develop from carinoma in situ or severe dysplasia known as conjunctival intraepithelial neoplasia cin. The diagnostic related groups drgs are a patient classification scheme which provides a means of relating the type of patients a hospital treats. Corneal squamous cell carcinoma scc is considered rare in the dog and often represents a secondary extension of a primary limbal or conjunctival neoplasia 1, 3, 4. Squamous cell carcinoma of the conjunctiva is the endstage of a spectrum of disease referred to as ocular surface squamous neoplasia ossn. The pictures in the left column are before staining and those on the right after staining.
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