Squamous cell carinoma eye lis presentin as unilateral: Blepharoconjunctivitis

ABSTRACT

Two rare cases of squamous cell carcinoma [Scc] of eyelid presented with chronic unilateral blepharoconjunctivitis are jointly reported by Ophthalmology and Histopathology Departments of Jinnah Postgraduate Medical Centre, Karachi. Histopathological examination of resected tumor and reconstruction of eyelids with different surgical techniques was carried out in both the cases. No local recurrence was seen in 10 and 2 years of follow-up. Both of them, however, developed dry eyes with its complications. It was concluded that unilateral chronic blepharoconjunctivitis, not responding to medical treatment, should be subjected to histopathological examination to find out the cryptogenic cause of inflammation and extensive eyelids surgery in oculoplastic procedures may ultimately end up in dry eye. Case I. Sixty-five years old lady with unilateral blepharoconjunctivitis of five years standing reported out to be SCC on incision biopsy. Both of her right upper and lower lids were resected with 0.5 to 1.0 cm apparently healthy margin. Reconstruction of anterior lamina was done by glabellar and forehead flap for upper lid and Mastarde's flap for lower lid. Inner lamina was reconstructed with buccal mucosa. Ten years of follow-up showed no evidence of recurrence, though, she did developed complications of dry eye. She was kept on local lubricants but despite of her regular use of artificial tears she developed total corneal opacity. Case II. Sixty-two years old male presented with right chronic blepharoconjunctivitis of 3 years standing. SCC was found to be underlying cause on incision of biopsy. Total right upper lid resection followed by reconstruction of upper lid was done. Skin [by local flap] used for outer lamina, while donor sclera for inner lamina. Due to shrinkage of sclera, root of the upper lid gave way. This defect was filled with Cuttler Beard lid sharing technique successfully. Upper lid was mobile and functional and patient did not had any evidence of recurrence in two years of follow-up. This patient developed dry eye and is being managed on lubricants