Shields J A, Shields C L, Gunduz K, Eagle R C
Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
Ophthalmic Plast Reconstr Surg. 1999 May;15(3):153-60. doi: 10.1097/00002341-199905000-00003.
To report five patients with intraocular invasion of conjunctival squamous cell carcinoma and to make recommendations regarding clinical recognition and treatment of this condition.
The authors reviewed the clinical records and pathology slides on five patients who had intraocular invasion of conjunctival squamous cell carcinoma, and they describe the presenting features and histopathology in these cases.
Intraocular invasion of conjunctival squamous cell carcinoma occurred in older patients who had one or more recurrences of a previously excised conjunctival epithelial tumor located near the comeoscleral limbus. The intraocular recurrence often was heralded by the onset of low-grade inflammation and secondary glaucoma, simulating a granulomatous iridocyclitis. A white mass generally was observed in the anterior chamber angle. Histopathologic examination revealed an ingrowth of malignant epithelial cells through the limbus with diffuse involvement of the anterior segment of the eye. The reported patients were managed by modified enucleation (standard enucleation with excision of affected conjunctival tissue). Metastatic disease did not develop in any of the patients.
The onset of signs of uveitis and glaucoma and a white mass in the anterior chamber angle in a patient with prior excision of a conjunctival squamous cell neoplasm tumor should raise suspicion of intraocular recurrence of conjunctival squamous cell carcinoma. Most affected patients require enucleation or subtotal orbital exenteration. The prognosis is good.
报告5例结膜鳞状细胞癌眼内侵犯患者，并对该疾病的临床识别和治疗提出建议。
作者回顾了5例结膜鳞状细胞癌眼内侵犯患者的临床记录和病理切片，并描述了这些病例的临床表现和组织病理学特征。
结膜鳞状细胞癌眼内侵犯发生在老年患者中，这些患者既往切除的位于角膜缘附近的结膜上皮肿瘤有一次或多次复发。眼内复发常以低度炎症和继发性青光眼的发作为先兆，类似肉芽肿性虹膜睫状体炎。在前房角通常可观察到白色肿物。组织病理学检查显示恶性上皮细胞通过角膜缘向内生长，累及眼前段。报告的患者采用改良眼球摘除术（标准眼球摘除术加切除受累结膜组织）进行治疗。所有患者均未发生转移性疾病。
既往有结膜鳞状细胞瘤切除史的患者出现葡萄膜炎和青光眼体征以及前房角白色肿物，应怀疑结膜鳞状细胞癌眼内复发。大多数受累患者需要眼球摘除术或眼眶内容物剜除术。预后良好。
