Clinicopathological analysis of 39 patients with corneal tumor

Corneal tumors are rare in clinical practice. There was a paucity of data on the incidence of various corneal tumors, their clinical and pathological features and surgical management, especially on large patient samples.

The medical records of 39 patients with corneal tumors referred to Zhongshan Ophthalmic Center, Sun Yat-sen University, China from Jan 1,1996 to Dec 31,2002 were reviewed retrospectively.

Of the 39 cases with corneal tumors, 31 were males and 8 were females. The right eye was affected in 24 cases and the left one in 15 cases. The mean age at diagnosis was 45.7 years, ranged from 3 to 88 years. Squamous cell carcinoma was the most common tumor in the cornea (18 cases, 46.15%), followed by pigmented naevus (12 cases,30.77 %), papillary epithelioma (3 cases, 7.69%), melanoma (1 case, 2.56%), oncosis hyperplasia(1 case, 2.56%) , inverting papilloma (1 case, 2.56%）, primary acquired melanosis (1 case, 2.56%) amyloid degeneration (1 case, 2.56%) inflammatory pseudotumor (1 case, 2.56%）. They arose most commonly in the limbal region. All tumors were unilaterally involved. Squamous cell carcinoma of the cornea usually appears as a whitish, rough, irregular lesion or a telangiectatic, gelatinous epibulbar mass. Nevus in the cornea generally becomes clinically apparent in the first or second decade of life and the lesion may enlarge or more deeply pigmented afterwards. The corneal tumors were completely excised microsurgically in 22 cases. Six cases were treated with surgical resection combined with amniotic membrane graft. Three cases with surgical excision plus transfer of conjunctival flap. Two cases with surgical excision plus lamellar keratoplasty. Two cases with surgical excision plus cryosurgery. Two cases with orbital exenteration. One case with enuleation. One case with incision biopsy and observation.

Squamous cell carcinoma and nevus, the most common corneal tumors, accounted for 76.92% of all cases. The therapeutic outcomes depended upon early pathologic diagnosis and early surgical management.