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Case Reports
. 2011:2011:972318.
doi: 10.1155/2011/972318. Epub 2011 Dec 29.

A case of squamous cell carcinoma of conjunctiva as initial sign of systemic cancers

Hayato Mitamura  1 , Toshiyuki Oshitari, Ryuta Kimoto, Jiro Yotsukura, Kaoru Asanagi, Takayuki Baba, Yoko Takahashi, Takashi Kishimoto, Shuichi Yamamoto
Affiliations
Case Reports

A case of squamous cell carcinoma of conjunctiva as initial sign of systemic cancers

Hayato Mitamura et al. Case Rep Ophthalmol Med. 2011.

Abstract

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. A 94-year-old woman without known systemic diseases developed a mass in her right conjunctiva. She was referred to our hospital 5 months after the onset. She was diagnosed with conjunctival SCC by biopsy. Systemic CT before the surgery revealed multiple liver lesions, lung legions, and a large mass surrounding the appendix. The patient requested the surgery, and the main aim of the surgery was cosmesis. Histopathological examinations of the specimen led us to the final diagnosis as SCC. She did not receive any other therapy because of her age. As no other surgical procedures were undertaken, it is uncertain as to whether the conjunctival lesion was primary or secondary. Although, it is extremely rare that SCC of the conjunctiva is the initial sign of systemic cancers, careful systemic examinations to find other cancers should be made.

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Figures

Figure 1
Figure 1
Photograph of the eye showing a large mass at the limbus that extended over the pupil (a and b) and postoperative photograph of the slit-lamp examination (c). Conjunctival tumor was almost excised with the nasal part of conjunctiva. No recurrence was observed until her death.
Figure 2
Figure 2
Images of systemic CT examination from the liver (a), the lung (b), and the abdomen (c). The arrow surrounding the appendix in the panel (c) may indicate the primary site of the cancer. The arrows in (a) show multiple metastasis of the liver. The arrow in (b) indicates the metastasis of the lung.
Figure 3
Figure 3
Histopathology of conjunctival tumor. The mass was composed of the sheet-like proliferation of atypical stratified squamous cells with outstanding papillary constructed growth pattern. The pleomorphic squamous cells showed numerous mitotic figures with dyskaratosis, loss of the nuclear polar, and lucid nucleolus. The histopathological diagnosis was well-differentiated type of squamous cell carcinoma.
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