Mucoepidermoid carcinoma of the conjunctiva with intraocular invasion

A 70-year-old man developed intraocular invasion from a recurrent tumor of the nasal perilimbal conjunctiva of the right eye six months after the original tumor had been resected. Examination of the enucleated right globe disclosed massive invasion of the nasal one-half of the anterior segment by a mucoepidermoid carcinoma of the conjunctiva. The neoplasm demonstrated mainly epidermoid features, including the production of a substantial amount of intraocular keratin. However, a segment of tumor along and within the iris stroma showed almost exclusively mucus-secretory features with a mucinous material within individual tumor cells and cysts lined by tumor cells. The original biopsy specimen demonstrated only the epidermoid and not the mucoid component of the carcinoma. Mucoepidermoid carcinoma of the conjunctiva appears to be more locally aggressive than conventional squamous cell carcinoma as is characterized by its tendency for early recurrence associated with a high incidence of intraocular and orbital invasion.