Primary conjunctival basal cell carcinoma treated with plaque brachytherapy: a rare case report

Primary basal cell carcinoma (BCC) of the conjunctiva is a rare tumor with only six cases reported in literature. We present the case of an 81-year-old male complaining of a slow-growing lesion in his right eye for the past 3 years. The lesion in the temporal bulbar conjunctiva was gelatinous and firmly adherent to sclera. Ultrasound biomicroscopy revealed apparent scleral thinning without invasion. Our provisional diagnosis was ocular surface squamous neoplasia; however, incisional biopsy for histopathological diagnosis revealed that it was a BCC. Due to scleral adhesion and thinning, the lesion was not amenable for surgical resection. Plaque brachytherapy was used to successfully treat the lesion. To the best of our knowledge, this is the first report of brachytherapy administration for treatment of this rare cancer. Previously reported cases were all nodular or pedunculated and treated with surgical excision. For flat, adherent, or invasive lesions, plaque brachytherapy is an effective primary treatment modality.