Squamous cell carcinoma of the conjunctiva as the initial finding of systemic cancers

1. Ryuta Kimoto
2. Toshiyuki Oshitari
3. Kaoru Asanagi
4. Jiro Yotsukura
5. Shuichi Yamamoto

Chiba University Graduate School of Medicine, Chiba, Japan

Purpose: To report a case of squamous cell carcinoma of the conjunctiva as the initial finding of the cancer of other organs.

Methods: A 94-year-old female without known systemic disease developed a conjunctival mass in her right eye. She referred to our hospital 4 months after the onset because she first rejected the further examinations and the treatment. She was diagnosed with conjunctival squamous cell carcinoma by biopsy. Systemic examinations before surgery were performed and she underwent excision of the tumor.

Results: CT scan as systemic examinations before surgery revealed multiple liver metastasis, multiple lung metastasis, and a large mass of the appendix. Thus the main aim of the operation was a cosmetic therapy. Histopathological examinations of the specimen indicated that the mass was squamous cell carcinoma, well differentiated type. The large mass of the appendix was suspected as a primary tumor. After surgery, she satisfied with no mass of the conjunctiva. We suggested that she had better take more systemic treatment such as chemotherapy or radiation, but she did not try to take more therapy because of her age.

Conclusions: Squamous cell carcinoma of the conjunctiva can be an initial finding of systemic cancers. Although it is an extremely rare case, careful systemic examinations to find other cancers should be required.