Extensive orbital invasion by conjunctival squamous cell carcinoma in an anophthalmic socket: a case report

We report the case of a 75-year-old man with conjunctival squamous cell carcinoma in his anophthalmic socket that had resulted from enucleation at age 5. He had a 6-week history of a palpable, right orbital mass and periocular pain. Examination revealed a right inferolateral orbital mass and keratinization of the inferior fornix. Magnetic resonance imaging revealed an extensive mass in the inferolateral orbit. Biopsy showed squamous cell carcinoma. The patient underwent exenteration with temporalis flap reconstruction followed by adjunctive radiotherapy. A metastasis to the right parotid was excised at 6 months. This case illustrates the potential for extensive orbital invasion and perineural spread by ocular surface squamous neoplasia in an anophthalmic socket despite minimal conjunctival signs.