Mucoepidermoid carcinoma of the conjunctiva with lung metastasis

• Main Authors: Pukhraj Rishi, Rashi Sharma, Krishnakumar Subramanian, Nirmala Subramaniam
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2015-01-01
• Series: Indian Journal of Ophthalmology
• Subjects: Community; digital imaging; Karnataka Internet-assisted Diagnosis of Retinopathy of Prematurity; retinopathy of prematurity; telemedicine; universal screening; Age-related macular degeneration; en-face optical coherence tomography; polypoidal choroidal vasculopathy; Choroid; enhanced depth imaging technique; swept source optical coherence tomography; Choroidal imaging; choroidal thickness; retinal dystrophies; Choroidal neovascularization; idiopathic juxtafoveal telangiectasis; juxtafoveal retinal telangiectasia; lutein; macular edema; macular pigment; macular telangiectasia; Müller cells; parafoveal telangiectasis; perifoveal telangiectasis; retinal angiomatous proliferation; retinal telangiectasis; subretinal neovascularization; zeaxanthin; Microscope-integrated optical coherence tomography; RESCAN; spectral domain optical coherence tomography; vitreoretinal surgery; Central reading center; randomized controlled trial; standard operating procedure; Fundus autofluorescence; lipofuscin; retina; retinal imaging; Cystoid macular edema; dexamethasone implant; external limiting membrane; optical coherence tomography; Ozurdex; serous retinal detachment; uveitis; Adaptive optics; axial length; cone density; myopia; Artifact; foveal diameter; foveal slope; ocular magnification; Emmetropization; hand-held; spectral-domain optical coherence tomography; visual acuity; Accommodating intraocular lenses; Crystalens HD; effective lens position; intraocular lenses power; keratometry; Choroidal thickness; dynamic exercise; exercise; Breast carcinoma; eye; metastasis; optic disk; optic nerve; tumor; Choroidal osteoma; enhanced depth imaging; morphology; Fundus autofluorescence imaging; retinal phototoxicity; solar radiation; Biopsy; conjunctiva; lung; mucoepidermoid carcinoma
• Online Access: http://www.ijo.in/article.asp?issn=0301-4738;year=2015;volume=63;issue=5;spage=457;epage=459;aulast=Rishi

A 36-year-old lady presented with redness and decreased vision in right eye since 6 months. She was earlier diagnosed of cavitary lung lesion, presumed secondary to tuberculosis and treated with anti-tubercular treatment for 4 months. Examination of affected right eye revealed nil light perception, conjunctival congestion with an exuberant mass in the inferotemporal bulbar conjunctiva, proptosis, iris neovascularization, 360° closed angles, intraocular pressure of 48 mm Hg, exudative retinal detachment, uveal mass and orbital extension. A diagnostic needle biopsy of uveal mass revealed malignant cells. Computed tomography-guided lung biopsy revealed squamous cell carcinoma (SCC), indicating metastatic spread from the orbit. She underwent lid-sparing exenteration of the right eye. Histopathological examination of the orbital tissue revealed mucoepidermoid carcinoma arising from the conjunctiva with extensive invasion into the orbital tissue, muscle fibers, sclera, choroid and optic nerve. Multiple tumor emboli were seen in the lumen of orbital blood vessels. In conclusion, mucoepidermoid carcinoma of the conjunctiva is a rare, aggressive variant of SCC. Early intervention is essential to prevent intraocular invasion and systemic metastasis.