Conjunctival Metastasis from Pleural Mesothelioma

Area of Science:

• Ophthalmology
• Oncology
• Pathology

Background:

• Pleural mesothelioma is a rare malignancy.
• Metastatic disease can occur in various organs, including the conjunctiva.
• Conjunctival tumors can present with diverse clinical features.

Observation:

• A 76-year-old male with advanced pleural mesothelioma developed a rapidly growing conjunctival mass.
• The conjunctival lesion appeared as a pink nodule on the bulbar conjunctiva.
• Histopathological examination revealed a solid and pseudo-papillary tumor.

Findings:

• Immunohistochemistry confirmed the conjunctival tumor was positive for cytokeratin (AE1/AE3), calretinin, WT1, and mesothelin.
• These markers confirmed the diagnosis of metastatic mesothelioma to the conjunctiva.
• The tumor's features mimicked metastatic carcinoma.

Implications:

• Rapidly growing conjunctival tumors with unusual morphology require immunohistochemical evaluation.
• A mesothelioma-specific panel is essential to differentiate metastatic mesothelioma from metastatic carcinoma.
• Accurate diagnosis is critical for appropriate patient management and prognosis.