Malignant transformation of a conjunctival keratoacanthoma requiring enucleation

doi: 10.7417/CT.2019.2113

  • A. L Díaz Díaz Fundación Oftalmológica de Santander (FOSCAL) , Cirugía plástica ocular, oncológica y órbita. Bucaramanga, Colombia
  • A. T. Hernández Fundación Oftalmológica de Santander (FOSCAL) , Cirugía plástica ocular, oncológica y órbita. Bucaramanga, Colombia
  • T. A. Chaparro Tapias Fundación Oftalmológica de Santander (FOSCAL) , Cirugía plástica ocular, oncológica y órbita. Bucaramanga, Colombia
  • R. Secondi
  • J. C. Sánchez España Ophthalmology Department. Hospital General. Granollers, España

Abstract

Purpose
We report a rare case of rapid transformation of a conjunctival keratoacanthoma (KA) into a highly aggressive squamous cell carcinoma requiring enucleation. To our knowledge, this is the second such case reported in the literature.


Methods
Case report


Results
A 73-year-old man presented with a recurrent conjunctival lesion in the right eye. A slit lamp examination revealed a hyperkeratotic lesion in the limbar conjunctiva adhered to deep planes but with no ocular involvement. An incisional biopsy was performed because an area of scleromalacia was observed underlying the lesion. Histological findings were consistent with conjunctival KA. One week later, a raised lesion was observed invading the anterior chamber. Histological examination of another excisional biopsy specimen indicated conjunctival squamous cell carcinoma. The right eye was enucleated. Histological analysis confirmed intraocular tumor invasion. Complete clinical remission was observed over one year of follow up.


Conclusions
Although conjunctival keratoacanthoma is normally benign, it is important to correctly differentiate between KA and squamous cell carcinoma, and closely monitor the eye after surgery because of the rare possibility of recurrence or conversion to squamous cell carcinoma. Immunohistochemistry could help in the diagnosis and management of dubious cases

Published
2019-04-16
How to Cite
DÍAZ DÍAZ, A. L et al. Malignant transformation of a conjunctival keratoacanthoma requiring enucleation. La Clinica Terapeutica, [S.l.], v. 170, n. 2, p. e81 - e83, apr. 2019. ISSN 1972-6007. Available at: <http://www.clinicaterapeutica.it/ojs/index.php/ClinicaTerapeutica/article/view/374>. Date accessed: 18 june 2019.