A unique collaboration of multidisciplinary experts from the european dermatology forum edf, the. Topical mitomycin c for partially excised ocular surface squamous. 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. Conjunctiva tumor an overview sciencedirect topics. Possible prognostic markers in conjunctival dysplasia and. Abstract objective to determine modifiable risk factors of ocular surface squamous neoplasia ossn in. Squamous cell carcinoma scc of the conjunctiva is a rare malignancy. However rather than combining recurrence results as a whole under ossn category, it is better to.
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. To investigate the risk factors for squamouscell carcinoma of the. Diagnosis and treatment of invasive squamous cell carcinoma. The diagnostic related groups drgs are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The epidemiology of conjunctival squamous cell carcinoma in uganda article pdf available in british journal of cancer 873. Aggressive conjunctival squamous cell carcinoma in a patient. The most common type of nonmelanocytic tumors include ocular surface squamous neoplasia and lymphoma. Shields et al 12 recently reported a case series of 5 patients with intraocular invasion of conjunctival squamous cell carcinoma. Characteristics, management, and outcome of squamous carcinoma. Risk factors for the disease are exposure to sun specifically occupational, exposure to uvb, and lightcolored skin.
Treatment of conjunctival papillomata with topical interferon alfa2b. Conjunctival squamous cell carcinoma is a cancer on the surface of the eye. See also spindle cell carcinoma, mucoepidermoid carcinoma. 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. Squamous cell carcinoma of the conjunctiva is usually a slowly progressive neoplasm that rarely invades the eye or orbit. Since the 1980s the number of patient presenting with squamous cell carcinoma of the conjunctival has been increasing exponentially. Commonly, squamous conjunctival neoplasia will contain characteristic corkscrewshaped blood vessels. After a mean follow up of 56 months 18226 months the rate of new or recurrent tumours was 4. The main risk factors for both are exposure to solar ultraviolet radiation outdoors, hivaids, human. When it spreads into the deeper tissues, it is known as invasive squamous cell carcinoma. Community eye health journal squamous cell carcinoma of the. Treatment of conjunctival squamous neoplasias with interferon. 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.
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. This study deals with the likelihood of intraocular invasion by conjunctival squamous cell carcinoma which is uncommon. Squamous cell carcinoma of the conjunctiva most commonly spreads superficially, extending into the conjunctival stroma and corneal epithelium. 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. 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. Cin is known by other names including bowens disease, conjunctival squamous dysplasia. Only very large squamous conjunctival cancers and those in patients who are immunosuppressed metastasize to other parts of the body. 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.
Risk factors for ocular surface squamous neoplasia in kenya. However, it is difficult to determine the grading of dysplasia by clinical morphologic findings. 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. The pictures in the left column are before staining and those on the right after staining. Clinical outcome of advanced squamous cell carcinoma of the. 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. It usually arises at the limbus as papillary exophytic greywhite mass. Jun 14, 2019 saegusa m, takano y, hashimura m, et al. Ocular surface squamous neoplasia ossn encompasses a broad spectrum of neoplastic squamous abnormalities of the conjunctival, limbal. Corneal and conjunctival intraepithelial neoplasia a case.
Learn more about the risk factors for basal and squamous cell skin cancer. 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. Rare but more common than basal cell carcinoma at this site in us, precancerous lesions are excised, so invasive carcinoma is uncommon rates. She was referred to our hospital 5 months after the onset.
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. 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. If untreated for an extensive period of time, the tumor can invade into the sclera, anterior chamber, andor orbit. Treatment of conjunctival squamous cell carcinoma treatment options cases percentage excision alone 4 26. A case of squamous cell carcinoma of conjunctiva as initial. Hpv type 16 in conjunctival and junctional papilloma, dysplasia, and squamous cell carcinoma. Squamous cell carcinoma of the conjunctiva is the endstage of a spectrum of disease referred to as ocular surface squamous neoplasia ossn. Squamous cell carcinoma of the conjunctiva is most common in caucasian individuals. Ossn is a malignant disease of the eyes that can lead to loss of vision and, in severe cases, death. Pdf the epidemiology of conjunctival squamous cell. Clinical outcome of advanced squamous cell carcinoma of.
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. The conjunctival epithelium merges into the nonkeratinized stratified. Ocular surface squamous neoplasia go to academy store learn more and purchase. 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. Ocular surface squamous neoplasia ossn is a spectrum of conjunctival diseases that.
Squamous carcinoma of the conjunctiva can form a nodule or diffusely spread out over the surface of the eye. Scc is the most common malignancy of the conjunctiva in the us, with a yearly incidence of 12. Since this type more commonly extends beneath the conjunctival epithelium, nodular tumors exhibit increased metastatic potential. Squamous cell carcinoma is locally invasive but rarely spreads to distant sites. Topical mitomycin c for extensive, recurrent conjunctivalcorneal squamous cell carcinoma. Sep 19, 2016 conjunctival tumors range from benign to malignant and lifethreatening. There is also a nodular type that is circumscribed, rapidly growing, and invasive. Combining with clinical features a diagnosis of invasive scc was given. It may develop from a papilloma, leukoplakia, intraepithelial epithelioma bowen disease, or spontaneous metaplasia. It is a slow growing tumor that arises from a single mutated cell on the ocular surface. Conjunctival squamous cell carcinoma with corneal stromal.
Squamous cell carcinoma is the most frequent malignant tumour of the conjunctiva. Pdf to retrospectively study 26 patients with squamous cell carcinoma scc of the ocular surface to determine pathological and clinical. Basal and squamous cell skin cancer causes, risk factors, and. Pdf squamous cell carcinoma of the conjunctiva researchgate. Treating squamous carcinomas of the conjunctiva and cornea. Wide excision, cryotherapy, amniotic membrane transplant can.
Invasive squamous cell carcinoma of the conjunctiva. Histologically, squamous carcinomas which arise in the conjunctival epithelium are well differentiated tumors. Pdf invasive squamous cell carcinoma of the conjunctiva. Atypia throughout full thickness of epithelium conjunctival intraepithelial neoplasia with individual tumor cells. Cancer of the conjunctiva squamous cell carcinoma of the.
The cytomorphology of ocular surface squamous neoplasia by using. Conjunctival squamous cell carcinomas sccs are rare neoplasms. But they can invade into and around the eye, into the orbit and sinuses. We report a case of a 24yearold man with a rapidly growing conjunctival mass. Conjunctival squamous cell carcinoma conjunctival scc and corneal intraepithelial neoplasia comprise what are called ocular surface squamous cell neoplasias. Keratoacanthoma of the conjunctiva in a young patient scielo. Conjunctival intraepithelial neoplasia cin is non invasive by definition. Patients with squamous cell carcinoma of the conjunctiva tend to be elderly, with an average age of 60 years. All patients showed excellent evolution without recurrence. This is believed to be due to occupational exposure to sunlight. Worldwide, conjunctival squamous cell carcinoma scc is an uncommon disease, the incidence of which varies geographically from 0. Incidence of squamouscell carcinoma of the conjunctiva and other. Ossn includes conjunctival andor corneal intraepithelial neoplasia, intraepithelial carcinoma of the.
It appears as a white or yellowpink nodule on the eye surface in the front of the eye where it can easily be seen. Images a and b show moderately differentiated squamous cell carcinoma, with deep royal blue staining. Squamous carcinoma and intraepithelial neoplasia of the. Squamous cell carcinoma is more common in males 75% than in females 25%. Conjunctival squamous cell carcinoma and conjunctival. Defined by abnormal malignant appearing epithelial cells replacing the entire conjunctival stratified squamous epithelial layer. Conjunctival squamous cell carcinoma wills eye hospital. Ocular surface squamous neoplasia ossn is a dysplasia of the conjunctival, limbal, or corneal epithelium,1 with a prevalence of 0. In situ carcinoma of the conjunctiva may be simply and successfully treated with surgical excision and cryotherapy. A 94yearold woman without known systemic diseases developed a mass in her right conjunctiva. Seen in age from 1860 years with the majority between 20 and 40 years.
The tumor was excised with a safety margin to exclude squamous cell. When carcinoma is confined to the epithelium, it is called corneal conjunctival intraepithelial neoplasia or carcinoma in situ or squamous intraepithelial neoplasia. Treatment of conjunctival squamous cell carcinoma with. Primary basal cell carcinoma of the conjunctiva with. 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. Basal and squamous cell skin cancer causes, risk factors, and prevention cancer.
Conjunctival lesions before and after staining with 0. Conjunctival intraepithelial neoplasia and scc are histopathologically welldefined conditions. Conjunctival squamous cell carcinoma scc can develop from carinoma in situ or severe dysplasia known as conjunctival intraepithelial neoplasia cin. This cme activity will discuss the latest treatment approaches for conjunctival squamous cell carcinoma and conjunctival intraepithelial neoplasia. Sometimes, many nodes might be removed in a more extensive operation called a. Abstract background the term ocular surface squamous neoplasia ossn.