White papules in lower right eyelid as a manifestation of mu
Squamous cell carcinoma (SCC) is the most common malignancy of the ocular surface. It is part of a pathologic continuum called ocular surface squamous neoplasia that includes localized lesions confined to the surface epithelium (dysplasia and intraepithelial neoplasia) and invasive SCC that invades the underlying stroma. Mucoepidermoid carcinoma (MEC) is a rare variant of conjunctival SCC and accounts for only 0.3% of all premalignant and malignant squamous lesions.

A 74-year-old woman presented to the ophthalmology department with a 2-month history of bloody secretions and redness of the right eye. She had a history of hypertension, type 2 diabetes, morbid obesity, dyslipidemia, and breast cancer (free of disease for 8 years). Physical examination showed 2 white papules in the conjunctiva of the right lower eyelid that were diagnosed as pyogenic granuloma.

An eyelid biopsy was performed. Histologic study showed a moderately differentiated SCC with numerous mucous cells and mitotic figures. Period acid-Schiff (PAS) stain highlighted areas of glandular differentiation. The patient was treated with local excision and adjuvant cryotherapy. Six months later, extensive clinicoradiologic workup, including brain and orbit magnetic resonance images, did not show any residual tumor or metastases.

Source: JAAD case reports

Read more: https://www.jaadcasereports.org/article/S2352-5126(19)30303-0/fulltext?rss=yes