Peripheral Ulcerative Keratitis With Associated Adjacent Scleritis : Unusual Presentation of Squamous Cell Carcinoma of the Conjunctiva

Abstract

Purpose: : To describe two cases of squamous cell carcinomas of the conjunctiva presenting with necrotizing scleritis with peripheral ulcerative keratitis.

Methods: : Design

Results: : One of patients had positive HIV test. No systemic association was found in either case. Episcleral and sclera biopsy samples revealed the presence of squamous cell carcinoma in both cases. Enucleation was performed in the two patients. Histological examination revealed that in both cases the SCC developed with intraocular extension without tumefaction.

Conclusions: : Rarely reported in the literature, anterior nodular scleritis may reveal the presence of a squamous cell carcinoma of the conjunctiva. Squamous cell carcinoma of the conjunctiva may be seen without a distinct mass and can masquerade as anterior nodular or necrotizing scleritis with PUK, delaying the correct diagnosis and allowing orbital and intraocular spread of the tumor. Episcleral and/or scleral biopsy should be performed when a scleritis shows atypical appearance or does not respond to the usual therapy.

Keywords: tumors • inflammation • sclera