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Bilateral ocular surface squamous neoplasia: a clinicopathological case report
  1. Y Usui1,2,
  2. G O Waring2,
  3. R F See2,3,
  4. N A Rao2,3,4,
  5. A C Marrone5
  1. 1Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan
  2. 2A Ray Irvine Ocular Pathology Laboratory, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
  3. 3Doheny Eye Institute, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
  4. 4Department of Ophthalmology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
  5. 5Department of Ophthalmology, Torrance Memorial Medical Center, Torrance, CA, USA
  1. Correspondence to: Yoshihiko Usui MD, Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan; usuyoshiaol.com

https://doi.org/10.1136/bjo.2003.029710

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    Ocular surface squamous neoplasia (OSSN) was first described by Lee and Hirst1 as an umbrella term that encompasses intraepithelial and invasive squamous cell carcinoma of the conjunctiva and cornea. The incidence of OSSN ranges from 0.02 to 3.5 per 100 000 population and varies geographically, with greater frequency near the equator. Generally, it is a slow growing tumour that rarely metastasises, but is capable of causing extensive local tissue destruction. Bilateral OSSN is extremely rare2–7 and offers a unique opportunity to study the biological characteristics of bilateral OSSN of the conjunctiva. The following case report describes the clinical presentation, histopathology, and immunohistochemical evaluation of tumour proliferation markers of a patient diagnosed with bilateral OSSN.

    Case report

    An 86 year old white woman was referred to the Doheny Eye Institute because of redness in her right eye that had developed over a period of several months. She had undergone a mastectomy in 1954. She had no history of ocular trauma, toxin exposure, or tobacco use. Her brother and sister died from liver cancer. An ophthalmic examination revealed a visual acuity of 20/100 in each eye. Ectropion and indurated lower eyelid margins were present bilaterally with no loss of cilia. A closer examination revealed a thickened epithelium that lined the palpebral conjunctiva and cul del sac of the right eye (fig 1A). The left lower palpebral …

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