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Squamous cell carcinoma in the anophthalmic socket: a series of four cases with HPV-16 profiling
  1. Lindsay A McGrath1,2,
  2. Sachin Madhusudan Salvi2,
  3. Soupramanien Sandramouli3,
  4. Rina Bhatt3,
  5. Kate Cuschieri4,
  6. Hardeep Singh Mudhar5
  1. 1 University of Queensland School of Medicine, Brisbane, Queensland, Australia
  2. 2 Sheffield Ocular Oncology Service, Royal Hallamshire Hospital, Sheffield, UK
  3. 3 Wolverhampton and Midland Counties Eye Infirmary, Wolverhampton, UK
  4. 4 Department of Laboratory Medicine, Scottish HPV Reference Laboratory, Royal Infirmary of Edinburgh, Edinburgh, UK
  5. 5 Department of Histopathology, National Specialist Ophthalmic Pathology Service (NSOPS), Royal Hallamshire Hospital, Sheffield, UK
  1. Correspondence to Dr Lindsay A McGrath, Sheffield Ocular Oncology Service, Royal Hallamshire Hospital, Sheffield S10 2JF, UK; lindsay.mcg{at}


Purpose To present the clinical and histological features of squamous cell carcinoma (SCC) in the anophthalmic socket in four adult patients, and to determine the presence of human papillomavirus infection (HPV).

Methods Retrospective case series of four adult patients with SCC of the anophthalmic socket. P16 immunohistochemistry and HPV testing was carried out in all cases. The authors report clinical findings, histopathology, management and outcomes for all four patients with conjunctival SCC. Previously reported cases of conjunctival SCC in anophthalmic sockets were reviewed.

Results Four adult patients presented with eyelid lumps, discharge or change in prosthesis fit. Common examination findings included papillomatous changes, eyelid masses and epithelial changes. Three out of the four cases (75%) were positive for p16 by immunohistochemistry and the same cases positive for HPV-16 DNA. All patients received cryotherapy, topical or intralesional chemotherapy. Two patients proceeded to exenteration for control of invasive disease.

Conclusions To the authors’ knowledge, this is the largest series of SCC in the anophthalmic socket with comprehensive annotation of HPV status. Although socket conjunctiva is protected from environmental radiation, there is still a risk of neoplastic transformation in this tissue, thus patient education and regular checking of sockets by ophthalmologists should be undertaken as a preventative measure. The potential role of HPV in these tumours warrants further investigation.

  • conjunctiva
  • neoplasia
  • diagnostic tests/investigation
  • ocular surface
  • orbit

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  • Contributors All authors contributed to the design and implantation of this research, to the analysis of the results and writing of the manuscript. 

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Royal Hallamshire Hospital.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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