Case Study: April 2016


A 65 year old male presents with a red nodule on the superior tarsal conjunctiva. It has been present for 12 months and gradually getter larger. It is beginning to feel uncomfortable. The patient had an enucleation for trauma 15 years previous and wears a prothetic eye.

The red nodule is biopsied.


1.What does Fig 1 show?

2. What do Fig 2 and 3 show?

3. What is the diagnosis?

4. What is the likliest cuase of the pathology?

Click to show answers

1. This shows atypical squamous epithelial cells replacing the normal tarsal conjunctival epithelium. This is in-situ squamous carcinoma.

2. This shows confluent nests of atypical squamous epithelial cells in the stroma. This represents invasive squamous carcinoma.

3. The overall diagnosis is in-situ and invasive squamous carcinoma.

4. The likliest cause is the irritation from the prosthesis.


Shields CL, Kancherla S, Bianciotto CG, Lally SE, Shields JA.Ocular surface squamous neoplasia (squamous cell carcinoma) of the socket: management of extensive tumors with interferon. Ophthal Plast Reconstr Surg. 2011 Jul-Aug;27(4):247-50.

Jain RK, Mehta R, Badve S.Conjunctival squamous cell carcinoma due to ocular prostheses: a case report and review of literature. Pathol Oncol Res. 2010 Dec;16(4):609-12

Barrett RV, Meyer DR, Carlson JA.Conjunctival squamous cell carcinoma in situ in the anophthalmic socket.Ophthal Plast Reconstr Surg. 2010 Jan-Feb;26(1):52-3

Nguyen J, Ivan D, Esmaeli B.Conjunctival squamous cell carcinoma in the anophthalmic socket. Ophthal Plast Reconstr Surg. 2008 Mar-Apr;24(2):98-101

Endo T, Hata J, Togashi S, Yanagibayashi S, Nakayama Y.Conjunctival squamous cell carcinoma of the orbit 40 years after enucleation. Ophthal Plast Reconstr Surg. 2006 Jul-Aug;22(4):299-301

Whittaker KW, Trivedi D, Bridger J, Sandramouli S.Ocular surface squamous neoplasia: report of an unusual case and review of the literature. Orbit. 2002 Sep;21(3):209-15. Review

Campanella PC, Goldberg SH, Erlichman K, Abendroth C. Squamous cell tumors and ocular prostheses. Ophthal Plast Reconstr Surg. 1998 Jan;14(1):45-9.