Inverted mucoepidermoid papillomas of the epibulbar conjunctiva.

Juxtalimbal epibulbar inverted papillomas that were locally excised without recurrence developed in two women, aged 42 and 51 at the time of initial presentation. There is only one previous report of this unusual conjunctival neoplasm, which documented involvement of the plical, caruncular, or tarsal conjunctiva. The tumor grew by acanthosis of the surface nonkeratinizing squamous epithelium, with invagination into the underlying connective tissue in the absence of inflammation or a tendency toward keratinization. The initial invaginations may be cystic in character, but solid lobules secondarily originated from their walls to push into the connective tissue. Mucus-producing goblet cells were scattered throughout the lesions; highly distinctive eosinophilic globoid bodies, probably reflecting inspissated mucoid material, were found in the walls of the cysts and entrapped within their secretions. Conjunctival inverted papilloma does not exhibit locally aggressive behavior, does not involve extensive segments of the conjunctival epithelium, and does not display diffuse spread or multicentricity. The authors therefore believe that it should be clearly separated from inverted squamous (Schneiderian) papillomas of the nasal cavity and sinuses.