Cancer of the Eye!
𝘖𝘤𝘶𝘭𝘢𝘳 𝘚𝘶𝘳𝘧𝘢𝘤𝘦 𝘚𝘲𝘶𝘢𝘮𝘰𝘶𝘴 𝘕𝘦𝘰𝘱𝘭𝘢𝘴𝘪𝘢 (𝘖𝘚𝘚𝘕)
Describes the entire spectrum of squamous neoplastic disease from dysplasia to carcinoma in situ and invasive SCC
𝐓𝐡𝐫𝐞𝐞 𝐠𝐫𝐚𝐝𝐞𝐬 (𝐋𝐞𝐞 𝐚𝐧𝐝 𝐇𝐢𝐫𝐬𝐭):
1) Benign Dysplasia
Papilloma
Pseudoepitheliomatous hyperplasia
Benign hereditary intraepithelial dyskeratosis
2) Preinvasive OSSN
Conjunctival/corneal carcinoma in situ
3) Invasive OSSN
Squamous carcinoma
Mucoepidermoid carcinoma
𝐄𝐭𝐢𝐨𝐥𝐨𝐠𝐢𝐜𝐚𝐥 𝐟𝐚𝐜𝐭𝐨𝐫𝐬:
● Old age
● Ultraviolet B radiation
● Males
● HPV infection
● HIV
● Xeroderma pigmentosum
● Chemical exposure
● Cigarette smoking
● Vitamin A deficiency
𝐂𝐥𝐢𝐧𝐢𝐜𝐚𝐥 𝐅𝐞𝐚𝐭𝐮𝐫𝐞𝐬:
● Most commonly in the interpalpebral area near the limbus
● Can extend across limbus to involve cornea
● Flat/Raised, pearly-gray or pink well-demarcated mass with feeder vessels
● Fluorescein/lissamine/rose bengal stain used to highlight the lesion
𝐌𝐨𝐫𝐩𝐡𝐨𝐥𝐨𝐠𝐢𝐜𝐚𝐥 𝐓𝐲𝐩𝐞𝐬:
1. 𝘗𝘭𝘢𝘤𝘰𝘪𝘥
-Gelatinous : Commonest, placoid lesion with shiny velvety surface, and tufted vessels
-Papilliform -Velvety
-Leukoplakic
2. 𝘕𝘰𝘥𝘶𝘭𝘢𝘳:
Well circumscribed elevated focal mass with mulberry appearance
3. 𝘋𝘪𝘧𝘧𝘶𝘴𝘦 variant:
Shows radial growth pattern without well defined margin and may mimic chronic blepharoconjunctivitis
Corneal involvement in OSSN gives a ground glass appearance with well defined borders or a beaten metal appearance on retroillumination
𝐃𝐢𝐚𝐠𝐧𝐨𝐬𝐢𝐬:
● Histopathology
● Impression Cytology
● AS OCT
● Confocal Microscopy
𝐌𝐚𝐧𝐚𝐠𝐞𝐦𝐞𝐧𝐭:
● Surgical excision with wide margins and edge cryotherapy
● Chemotherapy (MMC/5FU)
● Radiotherapy (Ruthenium-106)
● Immunotherapy with Interferon alpha 2b
Image from Rajan Eye Care Hospital
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