Case

A Caucasian woman in her eighties presented at our clinic with a reddish, papillomatous lesion covering the medial and inferior quadrants of the bulbar conjunctiva of the left eye. Duration of this lesion was unknown (fig 1A). As a squamous cell carcinoma was suspected, the tumour was surgically removed, and the resection margins treated by cryotherapy. Histopathological examination showed no signs of malignancy but did reveal a limbal papilloma (fig 1B).

One year later, a richly vascularised lesion reoccurred in the nasal and lower circumference and began to grow over the cornea. Histological examination of the tumour, which was excised in toto, again showed a papilloma, just like the specimen of another resection 4 months later.

The patient did not keep regular follow-up appointments after these operations.

Two years later, she presented with an advanced tumour recurrence of the nasal inferior conjunctiva. Even though parts of the infiltrated medial rectal muscle were sacrificed, and excision margins underwent freeze–thaw therapy, we were unable to excise the tumour in toto. This time, histological examination revealed not a papilloma but a well-differentiated squamous cell …