Squamous cell carcinoma of cornea

Purpose To report a case of isolated squamous cell carcinoma of cornea. Methods It is an observational case report. Results An 80-year-old man presented with decreased vision and a white gelatinous mass on his left cornea. Ocular examination revealed sparing of the limbus. There was no lymphadenopathy and no evidence of metastasis. The mass was excised completely with superficial keratectomy. Histopathology of the mass revealed it to be an invasive well-differentiated squamous cell carcinoma of cornea. Postoperatively mitomycin C (0.002%) eye drops were prescribed for 4 weeks. There has been no recurrence of the lesion till date. Conclusions Isolated squamous cell carcinoma of cornea, though a rare entity, should be kept in mind in patients with any corneal mass.     

Spontaneous regression of choroidal metastasis from renal cell carcinoma

PURPOSE: To describe a patient with choroidal metastasis from renal cell carcinoma that spontaneously regressed after nephrectomy. DESIGN: Interventional case report. METHOD: A 48-year-old Hispanic woman presented with reduced vision in the left eye attributable to an elevated choroidal lesion and associated exudative retinal detachment. Oncology workup revealed a left kidney renal cell carcinoma with pulmonary metastases. The patient underwent primary nephrectomy, without specific treatment of choroidal or pulmonary metastases. RESULTS: The metastatic choroidal lesion regressed and the retinal detachment completely resolved, as evidenced by fundus photographs and ultrasonography. CONCLUSIONS: Choroidal metastasis from renal cell carcinoma may spontaneously regress after removal of the primary tumor.     

Sphenoid Sinus Carcinoma Mimicking Retrobulbar Optic Neuritis

Sphenoid sinus carcinomas occur rarely compared with other sinonasal tumors. A case of sphenoid sinus squamous cell carcinoma presenting with acute, isolated optic neuropathy and visual loss is presented herein along with the related literature.

A 37-year-old man with sudden decrease in visual acuity in his left eye of 15 days’ duration was referred. He had received high-dose intravenous corticosteroid therapy with the provisional diagnosis of retrobulbar neuritis, and his visual acuity had temporarily improved at this time. Magnetic resonance study showed a space-occupying lesion in the left posterior ethmoid and sphenoid sinuses, adjacent to the intracanalicular optic nerve, and an increase in optic nerve signal intensity. An excisional biopsy of the sphenoid lesion revealed squamous cell carcinoma. After stereotactic radiotherapy and chemotherapy following surgery, a total loss of vision and optic atrophy developed in the left eye. No other complication, tumor recurrence, or metastasis occurred during 30 months of follow-up.     

Sphenoid sinus carcinoma mimicking retrobulbar optic neuritis

Sphenoid sinus carcinomas occur rarely compared with other sinonasal tumors. A case of sphenoid sinus squamous cell carcinoma presenting with acute, isolated optic neuropathy and visual loss is presented herein along with the related literature. A 37-year-old man with sudden decrease in visual acuity in his left eye of 15 days' duration was referred. He had received high-dose intravenous corticosteroid therapy with the provisional diagnosis of retrobulbar neuritis, and his visual acuity had temporarily improved at this time. Magnetic resonance study showed a space-occupying lesion in the left posterior ethmoid and sphenoid sinuses, adjacent to the intracanalicular optic nerve, and an increase in optic nerve signal intensity. An excisional biopsy of the sphenoid lesion revealed squamous cell carcinoma. After stereotactic radiotherapy and chemotherapy following surgery, a total loss of vision and optic atrophy developed in the left eye. No other complication, tumor recurrence, or metastasis occurred during 30 months of follow-up.     

Red lesions of the iris, choroid, and skin secondary to metastatic carcinoma of the thyroid: a review

An 83-year-old man was seen with a history of bilateral progressive loss of vision of 1 month's duration. On examination, there was a reddish, nodular lesion adjacent to the right side of the nose. Slit-lamp examination revealed a reddish iris mass in the left eye. Ophthalmoscopic examination revealed two orange choroidal lesions in the right eye and a large subretinal hemorrhage in the posterior pole with a central reddish vascular lesion in the left eye. An excisional biopsy of the skin lesion was performed. A diagnosis of metastatic follicular thyroid carcinoma was made according to the histopathologic findings and immunohistochemistry. The patient had no known history of thyroid malignancy and a metastatic survey revealed widespread metastasis. The patient had a total thyroidectomy followed by two series of radioactive iodine ablation. The iris lesion completely resolved and the choroidal lesions in the right eye showed partial regression during the follow-up period. Ocular and skin metastasis secondary to thyroid carcinoma is uncommon. In a review of English literature we found reports of 12 clinically well-documented cases of choroidal metastasis and two cases of iris metastasis. Our case and review of the previous cases reveal that reddish/orange color is a commonly observed feature of the uveal metastasis of thyroid carcinoma. Although ocular and skin metastases from thyroid carcinoma are rare, this possibility should be considered in the differential diagnosis of reddish-colored iris and choroidal masses as well as reddish nodular lesions of the scalp, face, and neck.     

显性结膜鳞状细胞癌1例

患者,男,37岁,以"右眼肿块迅速增大,无痛感5mo"就诊于我科.行眼科常规检查,发现一发白带蒂肿块位于右眼睑裂区角膜缘颞侧.遂行肿块切除术,手术成功.对切除肿块进行病理组织学检查,显示为分化良好的鳞状细胞癌.通过对此例居住在热带地区的亚裔患者发生的结膜鳞状细胞癌的诊治,认为长期的阳光照射是导致鳞状细胞癌发生的一个主要危险因素,提示我们对于任何眼表面病变都必须进行仔细的评估,进而正确诊断和治疗.     

Late choroidal metastasis secondary to papillary thyroid carcinoma.

PURPOSE: To report a case of late choroidal metastasis from papillary thyroid carcinoma. METHODS: Interventional case report. A 43-year-old woman who had been treated for papillary thyroid carcinoma 30 years earlier presented for evaluation of vision loss in the left eye. Eight weeks before this presentation, an ophthalmologist had diagnosed a metastatic uveal mass in the left eye of the patient. The clinical record was retrospectively reviewed. Ocular sonography was performed to confirm the diagnosis of choroidal metastasis. RESULTS: The choroidal mass had the typical characteristics of a metastatic lesion. The patient was treated with a combination of brachytherapy and chemotherapy. CONCLUSION: Papillary thyroid carcinoma can metastasize to the choroid many years after the initial diagnosis.     

Presumed eccrine carcinoma metastatic to the choroid

The purpose of this article is to describe a patient with presumed choroidal metastasis from an eccrine adenocarcinoma of the scalp. A 45-year-old Caucasian woman presented with decreased visual acuity. Ophthalmologic examination was unremarkable. Her past medical history was significant for eccrine carcinoma of the scalp. The patient developed bilateral cervical lymph node metastases, and received chemotherapy and radiotherapy. She had recurrence of the scalp lesion and developed bone metastasis. The patient was again referred to an ophthalmologist owing to reduced visual acuity. Multiple choroidal metastases were detected in right eye, and one metastatic lesion in left eye. The patient passed away 2 months after choroidal metastases. This is the first report of choroidal metastases from an eccrine carcinoma. This is a rare aggressive neoplasm with poor outcome in most cases of metastatic disease, and in this case report, uveal metastasis was indicative of poor prognosis.     

甲状腺髓样癌转移至虹膜角膜角1例

目的:报告甲状腺髓样癌在虹膜角膜角转移的病例1例。方法:患者,女,28岁,患有单一的甲状腺髓样癌伴左眼虹膜角膜角包块。随后几个月对其视网膜的随访显示其视网膜也有一些浸润病灶。结果:用激光照射姑息切除脉络膜及房角病灶后,没有发现有复发迹象和任何新病灶出现。结论:据我们所知,这是文献中第一次报告甲状腺髓样癌在虹膜角膜角的转移。     

Central retinal vein occlusion and renal cell carcinoma

PURPOSE: To document a case of central retinal vein occlusion (CRVO) associated with renal cell carcinoma and elevated levels of anticardiolipin and antiphospholipid antibodies. DESIGN: Observational case report. METHODS: History, clinical examination, chart review, and laboratory serologies were performed on a 63-year-old man with renal cell carcinoma with a 6-week history of decreased vision in his left eye. RESULTS: Vision was 20/40 in the left eye. Dilated fundus examination revealed a CRVO. Laboratory serologies revealed markedly elevated levels of anticardiolipin and antiphospholipid antibodies. CONCLUSION: This case illustrates an association between CRVO and renal cell carcinoma. A paraneoplastic process, consisting of both antiphospholipid and anticardiolipin antibodies, may be a mechanism for CRVO.     

Orbital metastasis from squamous cell carcinoma of the esophagus

PURPOSE. To describe a rare case of orbital metastasis from squamous cell carcinoma of the esophagus. METHODS. A 63-year-old man presented with intermittent left-sided headache. This was initially attributed to angle-closure glaucoma and bilateral peripheral laser iridotomies were performed. One month later, he developed left periorbital swelling. On reviewing the history, it was noted that he had undergone surgery for esophageal carcinoma. CT scan revealed a soft tissue mass in the left orbit, which on biopsy showed histologic features of metastatic squamous cell carcinoma. The patient died before palliative radiotherapy could be completed. DISCUSSION. Orbital metastasis from esophageal carcinoma is rare. In this case, the possibility of metastasis was overlooked at initial presentation, as there were no clinical signs to suggest it. Regardless of the primary tumor, the prognosis following orbital metastasis is poor. CONCLUSIONS. It is important to consider radiologic investigation when patients with systemic malignancy present with unexplained headache.     

Orbital metastasis of keratinizing squamous cell cervical carcinoma with giant cells. A case report

A case of orbital metastasis of cervical keratinizing squamous cell carcinoma is presented. The patient, in remission from primary cervical and ovarian cancers, presented with complaints of left eye ptosis and pain. Examination revealed the presence of a moderately tender mass along the left supra-temporal orbital rim and downward displacement of the left globe. Computed tomography revealed a poorly circumscribed mass with superior lateral wall bone loss. Excised tissue contained invasive, poorly differentiated nests of pan keratin and epithelial membrane antigen-positive squamous cells with numerous pleomorphic multinucleated giant cells. Multiple treatment regimes were unsuccessful, and the patient expired due to disease complications after 3 months.     

Gastric signet ring cell adenocarcinoma metastatic to the iris

PURPOSE: To report a case of gastric signet ring cell adenocarcinoma metastatic to the iris. METHODS: Case report. A 38-year-old man with a history of gastric signet ring cell adenocarcinoma presented with a white lacework-like mass on the iris of the left eye. RESULTS: Systemic medical evaluation demonstrated no other metastasis. Because of increased intraocular pressure, trabeculectomy and peripheral iridectomy were performed. Histology of the iris specimen demonstrated metastasis of gastric signet ring cell adenocarcinoma to the iris. CONCLUSION: Gastric signet ring cell carcinoma can metastasize to the iris. Ophthalmologists should include this possibility in the differential diagnosis when encountering a patient with a history of gastric adenocarcinoma and an iris mass.     

Squamous cell carcinoma with necrotizing scleritis

Purpose: To report on a case of limbal squamous cell carcinoma (SCC) with necrotizing scleritis in a young, previously healthy, white Australian male. Methods: A 31-year-old man presented with a left limbal lesion intermittently causing a red eye and foreign body sensation. He had enjoyed surfing for many years. Repeat HIV tests were negative and the lesion was biopsied. Results: Biopsy showed a well-differentiated SCC apparently arising in an intra-epithelial (in situ) carcinoma of the conjunctiva. The lesion was excised and a corneoscleral graft repair was performed. Conclusion: The present case highlights the potential for a significant increase in the prevalence of ocular surface neoplasia in healthy young people who have had excessive UV-B exposure.     

Squamous cell carcinoma with necrotizing scleritis.

PURPOSE: To report on a case of limbal squamous cell carcinoma (SCC) with necrotizing scleritis in a young, previously healthy, white Australian male. METHODS: A 31-year-old man presented with a left limbal lesion intermittently causing a red eye and foreign body sensation. He had enjoyed surfing for many years. Repeat HIV tests were negative and the lesion was biopsied. RESULTS: Biopsy showed a well-differentiated SCC apparently arising in an intra-epithelial (in situ) carcinoma of the conjunctiva. The lesion was excised and a corneoscleral graft repair was performed. CONCLUSION: The present case highlights the potential for a significant increase in the prevalence of ocular surface neoplasia in healthy young people who have had excessive UV-B exposure.     

Conjunctival squamous cell carcinoma of the orbit 40 years after enucleation

Conjunctival squamous cell carcinoma developed in a 51-year-old man 40 years after he had enucleation of his left eye because of an explosion injury. He had worn several ocular prostheses for more than 40 years. Recently he had noticed an increasing sanguineous conjunctival discharge, a foreign body sensation, and swelling of his left lower eyelid. Incisional biopsies of an underlying conjunctival mass revealed squamous cell carcinoma. His work history did not involve exposure to radiation, chemicals, or the sun. The authors concluded that squamous cell carcinoma in this case was caused by chronic irritation as the result of long-standing use of a poorly fitting ocular prosthesis.     

Systemic chemotherapy and tamoxifen induced regression of choroidal metastasis from a breast carcinoma in a male

We report a case of a 55-year-old male patient with breast carcinoma, who developed choroidal metastasis. The patient had undergone mastectomy for carcinoma of right breast, five years ago. The patient was advised close follow-up for the left eye, as he was already on tamoxifen therapy (started a month ago) for spinal metastasis. On last follow-up, a year later, the choroidal lesion had completely scarred, with no recurrences. Systemic hormonal therapy like tamoxifen given for the breast primary and other systemic metastases may cause regression of the choroidal metastasis, thereby avoiding ocular radiotherapy. Medline search revealed only one published case of regression of choroidal metastasis from a male breast primary, on tamoxifen therapy.     

Pigmented conjunctival squamous cell carcinoma simulating a conjunctival melanoma.

PURPOSE: To report a pigmented conjunctival squamous cell carcinoma that clinically simulated a conjunctival melanoma. DESIGN: Interventional case report. METHODS: Ocular examination, surgical excision, and clinicopathologic correlation. RESULTS: A 78-year-old white man developed a lightly pigmented mass at the temporal limbus of his right eye. The differential diagnosis included pigmented squamous cell carcinoma and malignant melanoma. Histopathologic examination revealed a malignant squamous cell tumor that contained foci of melanin pigment. The final diagnosis was pigmented conjunctival squamous cell carcinoma. CONCLUSION: Conjunctival squamous cell carcinoma may rarely be pigmented and simulate a conjunctival melanoma.     

Post-chemotherapy bilateral limbal stem cell deficiency

We report an extremely rare case of bilateral total limbal stem cell deficiency (LSCD) induced by long-term systemic chemotherapy for squamous cell carcinoma of the lung, and the outcomes of bilateral keratolimbal allograft transplantation (KLAT) in such a case. A 34-year-old male patient had underlying disease of squamous cell carcinoma in the right upper lung with extensive mediastinum and lymph node metastasis and received a series of systemic chemotherapy, including a combination of vinorelbine and cisplatin and a combination of gemcitabine, cisplatin, and docetaxel. According to clinical manifestations of ocular surface disorder, pathology findings, and immunostaining of cytokeratin 13 (CK13), LSCD secondary to systemic chemotherapy was diagnosed. KLAT was performed in both eyes. Although graft rejection developed in the right eye, complete re-epithelialization with favorable visual acuity occurred in the left eye 3 years after limbal transplantation.     

Bronchogenic squamous cell carcinoma presenting as cicatrizing conjunctivitis

PURPOSE: To report a case of cicatrizing conjunctivitis as the initial manifestation of a bronchogenic squamous cell carcinoma. METHODS: Case report of a 57-year-old patient with bilateral history of ocular pain, redness, and discharge, with no apparent predisposing factors. Examination revealed chemosis, pseudomembrane, and symblepharon formation, and multiple ulcerated pustular and vesicular periocular and perioral lesions literature review. RESULTS: Skin biopsy was compatible with bullous pemphigoid. Two months later he developed respiratory symptoms, and a squamous cell carcinoma was diagnosed. CONCLUSIONS: This case demonstrates cicatrizing conjunctivitis as a possible paraneoplastic syndrome associated with squamous cell lung carcinoma.