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Massive corneal and conjunctival squamous cell carcinoma.

A Panda1, N Sharma, S Sen

  • 1Dr. Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi.

Ophthalmic Surgery and Lasers
|September 8, 2000
PubMed
Summary

This study presents a successful treatment for massive conjunctival squamous cell carcinoma invading the cornea. The combined approach of frozen section guided excision, cryotherapy, and lamellar sclerokeratoplasty restored vision and prevented recurrence.

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Area of Science:

  • Ophthalmology
  • Oncology

Background:

  • Squamous cell carcinoma (SCC) of the conjunctiva can extensively invade the cornea.
  • Massive SCC poses a significant challenge to vision and ocular surface preservation.

Observation:

  • A patient presented with a large, protruding conjunctival squamous cell carcinoma extensively invading the cornea, resulting in hand motion visual acuity.
  • The tumor presented as a mass hanging from the ocular surface, indicating advanced disease.

Findings:

  • A microscopically-controlled, frozen section-guided excision was performed, ensuring complete tumor removal.
  • Adjuvant therapy included double-freeze-thaw cryoapplication to the sclera and conjunctival bed margins, followed by lamellar sclerokeratoplasty.
  • At three-year follow-up, the patient achieved a visual acuity of 20/60 with no evidence of tumor recurrence.

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Implications:

  • This combined therapeutic approach (excision, cryotherapy, lamellar keratoplasty) is a viable and effective treatment for massive squamous cell carcinoma of the cornea and conjunctiva.
  • Microscopic control and frozen section guidance are crucial for achieving complete tumor resection in complex ocular surface malignancies.
  • Adjuvant cryotherapy and lamellar keratoplasty play a significant role in preventing recurrence and restoring visual function in these challenging cases.