Conjunctival Intraepithelial Neoplasia in a Patient Presenting with Pigmented Conjunctival Lesion

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Abstract

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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Ocular surface squamous neoplasia

Lawrence Hirst, Graham A Lee (1995)

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Tumors of the conjunctiva and cornea.

Carol L. Shields, Jerry Shields (2015)

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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Author and article information

Journal

Journal ID (publisher-id): COP

Journal ID (pmc): COP

Journal ID (doi): 10.1159/issn.1663-2699

Title: Case Reports in Ophthalmology

Publisher: S. Karger AG

ISSN (Electronic): 1663-2699

Publication date Subscription-year: 2021

Publication date Collection: January - April 2021

Publication date (Electronic): 21 January 2021

Volume: 12

Issue: 1

Pages: 77-82

Affiliations

[_a] _aDepartment of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

[_b] _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

Article

Publisher ID: 510570 Pmcid ID: PMC7879333 Other ID: Case Rep Ophthalmol 2021;12:77–82

DOI: 10.1159/000510570

PMC ID: PMC7879333

PubMed ID: 33613255

SO-VID: 78cbe84c-97f5-4ca5-920d-6055a7bce568

License:

This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

History

Date received : 10 April 2020

Date accepted : 29 July 2020

Page count

Figures: 3, Pages: 6

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