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Case Reports
. 2021 Jan 21;12(1):77-82.
doi: 10.1159/000510570. eCollection 2021 Jan-Apr.

Conjunctival Intraepithelial Neoplasia in a Patient Presenting with Pigmented Conjunctival Lesion

Winai Chaidaroon  1 , Chutikarn Dejkriengkraikul  1 , Sirawit Isipradit  1 , Nirush Lertprasertsuke  2
Affiliations
Case Reports

Conjunctival Intraepithelial Neoplasia in a Patient Presenting with Pigmented Conjunctival Lesion

Winai Chaidaroon et al. Case Rep Ophthalmol. .

Abstract

We report a case of conjunctival intraepithelial neoplasia (CIN) in a patient presenting with the pigmented conjunctival lesion. This study involved a 56-year-old woman that presented with right eye irritation for 1 month. She noticed brownish pigmentation arising from her right nasal conjunctiva and growing slowly over time. Biomicroscopic examination showed a gelatinous pigmented conjunctival mass with feeder vessels. Conjunctival impression cytology (CIC) was done and reported as CIN. Treatment was started with 0.02% mitomycin-C eye drops. The conjunctival lesion responded well to medication. This report shows that CIN can manifest as a pigmented tumor, resembling melanoma. CIC plays a role in the diagnosis of this condition. This tumor responded well with 0.02% mitomycin-C eye drops.

Keywords: Conjunctival intraepithelial neoplasia; Conjunctival melanoma; Pigmented conjunctival lesion.

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Conflict of interest statement

There are no conflicts of interest to report for all authors.

Figures

Fig. 1
Fig. 1
a Slit lamp photographs of the right eye showed an elevated gelatinous pigmented mass with feeder vessels at the nasal side of the conjunctiva. bMagnification ×25.
Fig. 2
Fig. 2
Conjunctival impression cytology of the patient. a Low magnification (10×). The imprints are cellular with sheets and strand of highly dysplastic squamous cells. The background is clean without cellular necrosis. No melanocytic cells are found. b High magnification (40×). The dysplastic cells are polygonal with a high nuclear/cytoplasmic ratio. Their nuclei are hyperchromatic with irregular nuclear borders.
Fig. 3
Fig. 3
Photographs of the right eye before and after treatment. a At the first visit, an elevated gelatinous pigmented mass with feeder vessels at the nasal side of the conjunctiva. b After 1 cycle of treatment with 0.02% mitomycin-C, the pigmentation slightly alleviated with the regression of feeding vessels. c After treatment with 0.02% mitomycin-C for 2 cycles, the pigmentation of the conjunctiva and the feeding vessel were markedly decreased. d No pigmented conjunctival lesion was found after treatment with 0.02% mitomycin C for 3 cycles.
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