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. 2024 Apr;10(1):32-42.
doi: 10.1159/000531983. Epub 2023 Nov 15.

Intraocular Invasion by Conjunctival Squamous Cell Carcinoma: Clinical Presentation, Histopathological Findings, and Outcome

Ysé Borella  1 , Livia Lumbroso  1 , Christine Lévy  1 , Sophie Gardrat  2 , Jerzy Klijanienko  2 , Denis Malaise  1   3 , Rémi Dendale  4 , Nathalie Cassoux  1   3 , Alexandre Matet  1   3
Affiliations

Intraocular Invasion by Conjunctival Squamous Cell Carcinoma: Clinical Presentation, Histopathological Findings, and Outcome

Ysé Borella et al. Ocul Oncol Pathol. 2024 Apr.

Abstract

Introduction: Intraocular localization of conjunctival squamous cell carcinoma (SCC) is due to scleral or corneal invasion. Herein, we describe the clinical and histopathological findings in four cases of SCC complicated by intraocular invasion, and we review cases reported in the literature and their management. We retrospectively collected and analyzed clinical characteristics, histopathology, management, and follow-up data from 4 patients with conjunctival SCC complicated by intraocular invasion. We reviewed the literature and summarized cases of intraocular invasion by conjunctival SCC reported over the last 30 years.

Case presentations: Two patients presented with intraocular invasion by conjunctival SCC at diagnosis. The two others developed intraocular invasion as recurrence of conjunctival SCC, previously treated with excisional biopsy and adjuvant radiotherapy. All 4 cases had a previous history of conjunctival surgery, but no history of intraocular surgery. Three patients were managed with modified enucleation, including one that required adjuvant orbital radiotherapy. One patient required orbital exenteration. Histopathology analysis showed a well-differentiated conjunctival SCC in all cases. None developed distant localization after at least 2.5-year follow-up.

Discussion/conclusion: Intraocular invasion is a rare complication of conjunctival SCC. Appropriate treatment in a tertiary center and long-term follow-up are highly recommended.

Keywords: Anterior chamber; Conjunctiva; Enucleation; Radiotherapy; Squamous cell carcinoma.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1.
Fig. 1.
Case 1, clinical and histopathological aspect. a Local recurrence in 2014. b Local recurrence in 2017 with anterior chamber localization of the SCC. c Gonioscopy in 2017 showing angle invasion and multiple retrocorneal and iris nodules. d Histopathological analysis. Black arrow: infiltrated sclera. Yellow arrow: intraocular localization of SCC. Head arrow: extraocular localization of SCC.
Fig. 2.
Fig. 2.
Case 2, clinical and histopathological aspects. a Ulcerative lesion after excisional biopsy, July 2011. b Local recurrence in September 2012. c Exclusively intraocular recurrence in May 2013 manifesting by asymmetrical pupil, without lesion on the conjunctiva. d, e Gonioscopy showing anterior chamber invasion. f Histopathological analysis. Black arrow: infiltrated sclera. Yellow arrow: intraocular localization of SCC in the ciliary body.
Fig. 3.
Fig. 3.
Cases 3 (a, b) and 4 (c, d), clinical and histopathological aspect. a Case 3, clinical aspect at first visit, after pterygium surgery, with anterior chamber localization of SCC. b Case 3, UBM image with intraocular mass dimensions. c Case 4, clinical aspect. d Case 4, histopathological analysis. Black arrow: infiltrated sclera. Yellow arrow: intraocular localization of SCC.
See this image and copyright information in PMC

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