PDF(Pubmed)
Abstract：
Objective: To describe the morphological and histopathological features of primary conjunctival basal cell carcinoma (BCC) in a young adult Filipino. Introduction: Malignant conjunctival tumors arise from different cells, the most common of which are squamous cell carcinomas (SCCs), (including ocular surface squamous neoplasia [OSSN]), melanomas, and lymphomas. Primary conjunctival BCC is rare and can mimic the clinical features of OSSN. Only seven reported cases were published. Most cases are in the 6th-8th decades of life, and we report the first case in a young adult male. Case Summary: A 37/M, HIV-seronegative, presenting with a 3-year history of enlarging fleshy, pedunculated mass on the right eye measuring 8.5 mm × 8.0 mm at the superonasal limbus encroaching on the cornea, with prominent feeder vessels. Whitish-to-grayish plaques were observed on the surface of the lesions. Wide excision of the mass using the no-touch technique was performed under local anesthesia. Four cycles of mitomycin C (0.02%) were administered as chemoadjuvant therapy. Histopathology showed basaloid cells with peripheral palisading, most consistent with BCC. Immunohistochemistry was positive for Bcl-2 and CD10 markers and negative for epithelial membrane antigen (EMA) and carcinoembryonic antigen (CEA), confirming conjunctival BCC. Eight weeks postoperatively, fibrovascular tissue proliferation was noted at the excision site. Anterior segment-optical coherence tomography (AS-OCT) revealed a thickened hyperreflective band that was continuous with the epithelium, indicating possible recurrence. Resection with rush frozen section revealed fibrotic tissue that was negative for tumor cells. The bare sclera was covered with conjunctival autograft. There was no recurrence of the lesion after 16 months of follow-up. Conclusion: Primary BCC of the conjunctiva is rarely encountered, especially in young individuals, mimicking squamous neoplasia both in morphology and histopathology. Therefore, this should be considered in the differential diagnosis of OSSN. Immunostaining is crucial in differentiating between the two conditions and confirming the diagnosis. In most cases, wide surgical excision is sufficient. In addition, adjuvant therapies may be beneficial in preventing tumor recurrence.
摘要：
目的：描述菲律宾青年原发性结膜基底细胞癌（BCC）的形态学和组织病理学特征。简介：恶性结膜肿瘤起源于不同的细胞，其中最常见的是鳞状细胞癌（SCC），（包括眼表鳞状细胞瘤[OSSN]），黑色素瘤,和淋巴瘤。原发性结膜BCC很少见，可以模仿OSSN的临床特征。仅公布了7例报告病例。大多数病例都在生命的第六到第八十年，我们报告了第一例年轻成年男性病例。案例摘要:A37/M，HIV-血清阴性,具有3年的扩大肉质的历史，右眼上鼻缘侵犯角膜的带束肿块为8.5mm×8.0mm，有突出的支线船。在病变表面观察到白色至灰色的斑块。在局部麻醉下使用无接触技术对肿块进行广泛切除。给予4个周期的丝裂霉素C（0.02％）作为化学辅助疗法。组织病理学显示基底细胞样细胞伴外周栅栏，最符合BCC。免疫组织化学检测Bcl-2和CD10标记阳性,上皮膜抗原(EMA)和癌胚抗原(CEA)阴性,确认结膜BCC。术后8周,在切除部位观察到纤维血管组织增生。前段光学相干断层扫描（AS-OCT）显示与上皮连续的超反射带增厚，表明可能复发。急速冷冻切片切除显示纤维化组织，肿瘤细胞阴性。裸露的巩膜覆盖有结膜自体移植物。随访16个月后病灶无复发。结论：结膜原发性BCC很少见，尤其是年轻人，在形态学和组织病理学上都模仿鳞状细胞瘤。因此,在OSSN的鉴别诊断中应考虑这一点。免疫染色对于区分两种情况和确认诊断至关重要。在大多数情况下,广泛的手术切除就足够了。此外,辅助治疗可能有利于预防肿瘤复发。
