This is a 25 year old male patient, HIV positive, presenting with an extensive, white, hemispherical nodule covering the cornea, associated with a shallow AC
The eye is enucleated
Figure 1 is of the cornea and AC structures
Figure 2 is a higher power view with the ciliary body towards the bottom.
Figure 3 is a higher power lesion of the main pathology
What has happened to the cornea in Figure 1?
What is the lesion in Figure 2?
What is the final diagnosis?
Click to show answers
The cornea has been completely infiltrated and destroyed by a malignant neoplasm, entering from the corneal surface and invading the AC structures
Figure 2 shows the tumour in relation to the ciliary body
Invasive squamous cell carcinoma. The eyeball was enucleated with an extensive skirt of bulbar conjunctiva. The flat conjunctiva showed CIN3, giving rise to invasive SCC over the cornea with AC invasion
Berenbom A, Milman T, Finger PT FIT biopsy for conjunctival squamous cell carcinoma with extensive intraocular invasion.Graefes Arch Clin Exp Ophthalmol. 2008 Mar;246(3):467-9
Zhang Z, Li B, Shi J, Xu X, Li L, Gao F. Intraocular extension of conjunctival squamous cell carcinoma. Ophthalmologica. 2007;221(3):200-3.
Schlote T, Mielke J, Rohrbach JM. Massive intraocular invasion of conjunctiva by squamous cell carcinoma–a case report.
Klin Monbl Augenheilkd. 2001 Jul;218(7):518-21
Shields JA, Shields CL, Gunduz K, Eagle RC Jr The 1998 Pan American Lecture. Intraocular invasion of conjunctival squamous cell carcinoma in five patients. Ophthal Plast Reconstr Surg. 1999 May;15(3):153-60