Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
BMJ Case Rep. 2020 Nov 9;13(11):e235789. doi: 10.1136/bcr-2020-235789.
Primary corneal neoplasia (PCN) is a rare cancerous lesion of cornea usually encountered in elderly. The clinical symptoms are generally non-specific, with ocular irritation, redness, cosmetic disfigurement and varying degrees of visual disturbances depending on visual axis involvement. Corneal neoplasia is usually associated with surrounding conjunctival lesions and incidentally detected PCN is rarely encountered in clinical practice. Presently, we report a case of isolated unilateral PCN diagnosed incidentally in an elderly man presenting with cataract. In vivo confocal microscopy aided in its diagnosis after impression cytology was repeatedly negative. Cataract surgery was deferred and the patient was administered three cycles of mitomycin C 0.04% 4 times/day. The tumour margins receded as evident on clinical examination and on anterior segment optical coherence tomography. We discuss the role of various corneal imaging modalities in diagnosis and management of PCN besides highlighting importance of comprehensive slit-lamp examination in patients planned for cataract surgery.
原发性角膜肿瘤（PCN）是一种罕见的角膜癌性病变，通常发生在老年人。其临床症状通常不具特异性，表现为眼部刺激、发红、外观损害以及不同程度的视力障碍，具体取决于视觉轴的受累情况。角膜肿瘤通常与周围的结膜病变相关，临床上很少偶然发现孤立性单侧 PCN。目前，我们报告了 1 例孤立性单侧 PCN 的病例，该病例发生在 1 位老年男性白内障患者中。在多次印迹细胞学检查阴性后，活体共聚焦显微镜辅助诊断。为避免肿瘤扩散，我们推迟了白内障手术，并给予患者每日 4 次共 3 个周期的 0.04%丝裂霉素 C 治疗。临床检查和眼前节光学相干断层扫描显示肿瘤边缘退缩。我们讨论了各种角膜成像方式在 PCN 诊断和管理中的作用，同时强调了在计划行白内障手术的患者中全面裂隙灯检查的重要性。
