Multifocal squamous cell carcinoma of the conjunctiva with intraocular penetration in a patient with AIDS

Abstract

Purpose: To describe the clinical findings and to study the histopathology of conjunctival masses in a patient with HIV infection.

Methods: A case report.

Results: The histopathology from a 38-year-old Thai female patient who presented with visual loss on the left eye was studied. She had been diagnosed with AIDS 3 years before and was treated with highly active antiretroviral therapy and anti-tuberculous drugs for 1 year. The left eye was blind and showed 2 separate whitish masses on the bulbar conjunctiva in adjacent to the inferomedial limbus. Multiple nodules under the conjunctiva were seen inferiorly. Computerized tomography of the orbit revealed slight thickening of the left lower eyelid but could not show any globe involvement. The patient underwent orbital exenteration. Gross pathology showed multiple areas of the tumor. Histopathology revealed dysplastic squamous epithelium invading into the substantia propria of the conjunctiva with intraocular penetration. The anterior surface of the iris was filled with tumor cells containing keratin pearls.

Conclusion: Squamous cell carcinoma can be multifocal and aggressive in HIV-infected patients. Rapid progression to intraocular penetration can be observed.