Kaines Andrew, Davis Garry, Selva Dinesh, Leibovitch Igal, Dodd Thomas, Malhotra Raman
Oculoplastic & Orbital Clinic, Department of Ophthalmology, Royal Adelaide Hospital, Australia.
Ophthalmic Surg Lasers Imaging. 2005 May-Jun;36(3):249-51.
Conjunctival squamous cell carcinoma is generally a low-grade malignancy. A 42-year-old man presented with histologic evidence of extra-tumoral perineural invasion associated with an incompletely excised limbal conjunctival squamous cell carcinoma. Despite further surgery, close observation, plaque radiotherapy, and eyelid-sparing orbital exenteration followed by external beam radiotherapy, the patient developed intracranial perineural invasion with involvement of the trigeminal and facial nerves, ultimately resulting in death. Repeated magnetic resonance imaging with contrast failed to detect perineural invasion until late in the course of disease. Awareness of the possibility of perineural invasion in patients with conjunctival squamous cell carcinoma and of its aggressive nature may be life-saving. Nevertheless, even with initial aggressive tumor control, some patients will show an aggressive tumor growth with recurrences.
结膜鳞状细胞癌通常是一种低级别恶性肿瘤。一名42岁男性患者，其组织学证据显示存在与未完全切除的角膜缘结膜鳞状细胞癌相关的肿瘤外神经周围浸润。尽管进行了进一步手术、密切观察、敷贴放疗、保留眼睑的眼眶内容剜除术并随后进行外照射放疗，但该患者仍发生了颅内神经周围浸润，累及三叉神经和面神经，最终导致死亡。在疾病病程后期之前，反复的增强磁共振成像未能检测到神经周围浸润。认识到结膜鳞状细胞癌患者发生神经周围浸润的可能性及其侵袭性本质可能会挽救生命。然而，即使最初对肿瘤进行积极控制，一些患者仍会出现侵袭性肿瘤生长并复发。
