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      Conjunctival Intraepithelial Neoplasia in a Patient Presenting with Pigmented Conjunctival Lesion

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          We report a case of conjunctival intraepithelial neoplasia (CIN) in a patient presenting with the pigmented conjunctival lesion.This study involved a 56-year-old woman that presented with right eye irritation for 1 month. She noticed brownish pigmentation arising from her right nasal conjunctiva and growing slowly over time. Biomicroscopic examination showed a gelatinous pigmented conjunctival mass with feeder vessels. Conjunctival impression cytology (CIC) was done and reported as CIN. Treatment was started with 0.02% mitomycin-C eye drops. The conjunctival lesion responded well to medication. This report shows that CIN can manifest as a pigmented tumor, resembling melanoma. CIC plays a role in the diagnosis of this condition. This tumor responded well with 0.02% mitomycin-C eye drops.

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          Most cited references 16

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          Tumors of the conjunctiva and cornea.

          Tumors of the conjunctiva and cornea comprise a large and varied spectrum of conditions. These tumors are grouped into two major categories of congenital and acquired lesions. The acquired lesions are further subdivided based on origin of the mass into surface epithelial, melanocytic, vascular, fibrous, neural, histiocytic, myxoid, myogenic, lipomatous, lymphoid, leukemic, metastatic and secondary tumors. Melanocytic lesions include nevus, racial melanosis, primary acquired melanosis, melanoma, and other ocular surface conditions like ocular melanocytosis and secondary pigmentary deposition. The most frequent nonmelanocytic neoplastic lesions include squamous cell carcinoma and lymphoma, both of which have typical features appreciated on clinical examination. The caruncle displays a slightly different array of tumors compared to those elsewhere on the conjunctiva, as nevus and papilloma are most common, but oncocytoma and sebaceous gland hyperplasia, adenoma, and carcinoma can be found. In this report, we provide clinical description and illustration of the many conjunctival and corneal tumors and we discuss tumor management.
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            Ocular surface squamous neoplasia.

             G A Lee,  L Hirst (2016)
            Ocular surface squamous neoplasia presents as a spectrum from simple dysplasia to carcinoma in situ to invasive squamous cell carcinoma involving the conjunctiva as well as the cornea. It is a distinct clinical entity, although it has been known by a variety of different names throughout the literature. Most commonly it arises in the limbal region, occurring particularly in elderly males who have lived in geographic areas exposed to high levels of ultraviolet-B radiation. Symptoms range from none to severe pain and visual loss. The development of preoperative diagnostic techniques, such as impression cytology, are of value in clinical decision making and follow-up management. Simple excision with adequate margins is currently the best established form of treatment despite trials of other modalities. The course of this disease may be evanescent, but is more frequently slowly progressive and may require exenteration and occasionally may lead to death.
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              Ocular surface squamous neoplasia


                Author and article information

                Case Reports in Ophthalmology
                S. Karger AG
                January - April 2021
                21 January 2021
                : 12
                : 1
                : 77-82
                aDepartment of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
                bDepartment of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
                Author notes
                *Winai Chaidaroon, Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200 (Thailand), hanumanthai777@gmail.com
                510570 PMC7879333 Case Rep Ophthalmol 2021;12:77–82
                © 2021 The Author(s). Published by S. Karger AG, Basel

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                Figures: 3, Pages: 6
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