Shields CL, Manchandia A, Subbiah R, Eagle RC, Shields JA. Pigmented squamous cell carcinoma in situ of the conjunctiva in 5 cases.
Ophthalmology 2008;
115:1673-8. [PMID:
18378314 DOI:
10.1016/j.ophtha.2008.01.020]
[Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2007] [Revised: 01/15/2008] [Accepted: 01/16/2008] [Indexed: 11/27/2022] Open
Abstract
PURPOSE
To describe 5 patients with pigmented conjunctival squamous cell carcinoma in situ.
DESIGN
Retrospective noncomparative case series.
PARTICIPANTS
Five patients.
METHODS
Clinical and histopathologic features were reviewed.
MAIN OUTCOME MEASURES
Relationship of clinical and histopathologic features to carcinoma pigmentation.
RESULTS
All 5 patients were male. Two were Hispanic, 2 were Caucasian, and 1 was Asian Indian. Localized racial melanosis was evident in 3 cases and no case showed diffuse racial melanosis. The tumor showed leukoplakia (n = 1) and was at the temporal limbus (n = 4) or nasal limbus (n = 1). The mean tumor basal dimension was 9.2 mm and mean thickness was 3.2 mm. Brown pigment was present deep within the tumor in all 5 cases, involving 50% to 90% of the mass. In each case, pigmented squamous cell carcinoma was suspected; melanoma was a second possibility. Histopathology revealed in situ squamous cell carcinoma (conjunctival intraepithelial neoplasia) with pigmented dendritic melanocytes in all 5 cases. Pigment was also found within neoplastic cells (n = 2). After surgical resection, there was no recurrence over mean follow-up of 23 months.
CONCLUSIONS
Squamous cell carcinoma in situ can manifest as a pigmented tumor, resembling melanoma, in both Caucasians and non-Caucasians, primarily due to intratumoral pigmented dendritic melanocytes.
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