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Updated: Jul 6, 2026
Anterior High-Resolution Optical Coherence Tomography in the Diagnosis and Therapeutic Monitoring of Ocular Surface Squamous Neoplasia
Published on: August 9, 2024
Pigmented squamous cell carcinoma in situ of the conjunctiva in 5 cases
Carol L Shields1, Ajay Manchandia, Rajeeve Subbiah
1Ocular Oncology Service, Wills Eye Institute, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA. carol.shields@shieldsoncology.com
Purpose:
To describe 5 patients with pigmented conjunctival squamous cell carcinoma in situ.
Design:
Retrospective noncomparative case series.
Participants:
Five patients.
Methods:
Clinical and histopathologic features were reviewed.
Main Outcome Measures:
Relationship of clinical and histopathologic features to carcinoma pigmentation.
Results:
All 5 patients were male. Two were Hispanic, 2 were Caucasian, and 1 was Asian Indian. Localized racial melanosis was evident in 3 cases and no case showed diffuse racial melanosis. The tumor showed leukoplakia (n = 1) and was at the temporal limbus (n = 4) or nasal limbus (n = 1). The mean tumor basal dimension was 9.2 mm and mean thickness was 3.2 mm. Brown pigment was present deep within the tumor in all 5 cases, involving 50% to 90% of the mass. In each case, pigmented squamous cell carcinoma was suspected; melanoma was a second possibility. Histopathology revealed in situ squamous cell carcinoma (conjunctival intraepithelial neoplasia) with pigmented dendritic melanocytes in all 5 cases. Pigment was also found within neoplastic cells (n = 2). After surgical resection, there was no recurrence over mean follow-up of 23 months.
Conclusions:
Squamous cell carcinoma in situ can manifest as a pigmented tumor, resembling melanoma, in both Caucasians and non-Caucasians, primarily due to intratumoral pigmented dendritic melanocytes.
