[Mucoepidermoid carcinoma of the epibulbar connective tissue with diffuse intraocular epithelial invasion]

A 55-year-old man was treated twice with local excision and crycoagulation for a recurrent limbal mass of the left eye. The original histologic diagnosis was squamous cell carcinoma. Three months after the last recurrence the globe was enucleated because of a spontaneous perforation at the corneoscleral limbus with iris prolapse. Histologic examination, including PAS and mucicarmine stains, revealed a mucoepidermoid carcinoma of the epibulbar conjunctiva with infiltration of the cornea, sclera, iris and ciliary body.

Examination of specially stained sections (e.g. with mucicarmine) should be routinely performed for those conjuctival neoplasms that contain a squamous component. Aggressive surgical management, such as early enucleation including normal appearing tissue next to the globe, should be considered for treatment of primary mucoepidermoid carcinoma to avoid later exenteration or metastasis.