Pigmented squamous cell carcinoma in situ of the conjunctiva in 5 cases.
OBJECTIVE
To describe 5 patients with pigmented conjunctival squamous cell carcinoma in situ.


METHODS
Retrospective noncomparative case series.


METHODS
Five patients.


METHODS
Clinical and histopathologic features were reviewed.


METHODS
Relationship of clinical and histopathologic features to carcinoma pigmentation.


RESULTS
All 5 patients were male. Two were Hispanic, 2 were Caucasian, and 1 was Asian Indian. Localized racial melanosis was evident in 3 cases and no case showed diffuse racial melanosis. The tumor showed leukoplakia (n = 1) and was at the temporal limbus (n = 4) or nasal limbus (n = 1). The mean tumor basal dimension was 9.2 mm and mean thickness was 3.2 mm. Brown pigment was present deep within the tumor in all 5 cases, involving 50% to 90% of the mass. In each case, pigmented squamous cell carcinoma was suspected; melanoma was a second possibility. Histopathology revealed in situ squamous cell carcinoma (conjunctival intraepithelial neoplasia) with pigmented dendritic melanocytes in all 5 cases. Pigment was also found within neoplastic cells (n = 2). After surgical resection, there was no recurrence over mean follow-up of 23 months.


CONCLUSIONS
Squamous cell carcinoma in situ can manifest as a pigmented tumor, resembling melanoma, in both Caucasians and non-Caucasians, primarily due to intratumoral pigmented dendritic melanocytes.
Shields
Carol L
CL
Ocular Oncology Service, Wills Eye Institute, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA. carol.shields@shieldsoncology.com
Manchandia
Ajay
A
Subbiah
Rajeeve
R
Eagle
Ralph C
RC
Shields
Jerry A
JA
D000328:Adult; D000368:Aged; D002278:Carcinoma in Situ / Q000473:pathology*; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D003230:Conjunctival Neoplasms / Q000473:pathology*; D006801:Humans; D016850:Limbus Corneae / Q000473:pathology; D008297:Male; D008544:Melanocytes / Q000473:pathology*; D008875:Middle Aged; D012189:Retrospective Studies