Case #9: Squamous Conjunctival Neoplasia

By Paul T. Finger, MD

History#1

1A man with a past ocular history of glaucoma (status-post trabeculectomy) and macular degeneration was referred to The New York Eye Cancer Center with squamous conjunctival neoplasia affecting his right eye.

One might imagine that he is at high risk for intraocular infiltration of his tumor.

Impression

Squamous Conjunctival Neoplasia

High-frequency Ultrasonography reveals the open sclerostomy (black arrow) and the overlying low-reflective tumor (white arrow). Note that the ciliary body is highly reflective (unlike the tumor). A multicystic bleb is noted on transverse section. High-frequency ultrasound obtained with the 20 MHz probe.
High-frequency Ultrasonography reveals the open sclerostomy (black arrow) and the overlying low-reflective tumor (white arrow). Note that the ciliary body is highly reflective (unlike the tumor). A multicystic bleb is noted on transverse section. High-frequency ultrasound obtained with the 20 MHz probe.

Note: With NO evidence of intraocular invasion, this patient was treated by tumor resection, superficial keratectomy, and adjuvant cryotherapy (to the episclera and conjunctival margins).

Comment: This case presents an unusual case of squamous conjunctival neoplasia that had grown over a functioning filtering bleb.

Findings on high-frequency ultrasound and the presence of iris neovascularization can be helpful in determining if squamous conjunctival neoplasia has infiltrated the eye.

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