Abstract
Purpose :
Conjunctival keratoacanthomas are rare, low-grade, hyperkeratotic crateriform tumors. The purpose of this study was to investigate the clinical, histopathological, immunohistochemical, and diagnostic imaging results that define conjunctival keratoacanthomas.
Methods :
Retrospective chart reviews of 8 patients with pathologically confirmed conjunctival keratoacanthomas were performed. The demographics, clinical history, diagnostic testing (slit-lamp photography, high-resolution anterior segment optical coherence tomography, and high-resolution ultrasound biomicroscopy images), treatment modalities, histopathology, immunohistochemical testing, visual outcomes, and recurrences were extracted after identifying the patients in a database search of the Florida Lions Ocular Pathology Laboratory records.
Results :
The mean age of the 8 identified patients was 54.5 years + 22.4 years. 75% (6/8) of patients were male and 62.5% (5/8) were of Hispanic ethnicity. All lesions were rapidly growing, white nodular lesions located on the bulbar conjunctiva located in the interpalpebral exposure zone. All lesions were surgically excised, and two underwent partial spontaneous resolution prior to surgery. No cases recurred at up to one year of follow-up. A prominent keratin-filled cup-shaped lesion with faulty maturational sequencing that extended full thickness with variably pale cytoplasm and foci of dyskeratosis and hyperkeratosis was present on histopathology in all cases. Hyper-reflective, thickened epithelium often overlying disorganized subepithelial tissue was seen on high-resolution anterior segment optical coherence tomography.
Conclusions :
Conjunctival keratoacanthomas are rare lesions of the ocular surface with distinct clinical, histopathologic, and diagnostic features. Further research is required to better understand the clinical course and optimal treatment approach of this rare condition.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.