Massive intraocular invasion of a squamous cell carcinoma of the conjunctiva - a case report

Background: Squamous cell carcinoma of the conjunctiva is a mostly solitary growing tumor located at the limbus region, which seldom invades the eye. We present an unusual case of conjunctival carcinoma with marked intraocula r involvement, which appeared primarely as a chronic inflammation with corn eal ulcer. Case report: A 89-year-old female patient was referred to our institution w ith a suspected ulcus rodens of the cornea. Since one year a refractory con junctivitis persisted despite of different local treatment. At first presen tation, a marked bacterial keratokonjunctivitis with circular necrosis of t he conjunctiva, corneal infiltration and perforation was seen. Visual acuit y of the right eye was light perception. The left eye was unremarkable. Enu cleation of the right eye was performed. Histopathologic examination reveal ed the diagnosis of squamous cell carcinoma of the conjunctiva with intraoc ular involvement. There was a marked infiltration of the choroid even behin d the equator. No metastases were found. Conclusion: Advanced squamous cell carcinoma associated with superinfection may present as a primary inflammatory process. There may be extensive invo lvement of the choroid. Metastases are probably rare even in advanced cases of this type of carcinoma.