EPIDERMOID CONJUNCTIVE CARCINOMA : ABOUT 16 CASES

 Malignant tumors are much rarer, but should always be present in the mind of the ophthalmologist. The most represented is conjunctival squamous cell carcinoma (CEC) which is one of the differentiated squamous tumors. It is recognized as having a long precancerous course including multiple dysplasias until carcinoma in situ (CIS) which progresses slowly. 

ophtalmology B Departement ,speiality hospital of ibn sina ,Rabat ,Morocco .

We report a retrospective study conducted at the Ophthalmology B service in Rabat, involving 16 cases collected between June 2019 and December 2020. Our patients presented with conjunctival and / or corneal lesions. Treatment consisted of carcinological tumor excision supported by data from pathological examinations. 

The average age of our patients is 62.7 years, apart from the children followed for Xeroderma pigmentosum whose average age is 11 years with extremes of 4 years and 26 years, without sex ratio with an average diagnostic delay of 23 months. The clear phototype represents a constant risk factor in 25% of cases. 2 patients were strongly exposed to the sun in their professional environment having exercised an activity in the open air; 55% of patients are followed for Xeroderma pigmentosum.

Slit lamp Examination of the patients found localized polymorphic tumor, corneal and conjunctival lesions. The anatomopathological study after incisional biopsy revealed squamous cell carcinoma in situ in 4 patients and invasive squamous cell carcinoma in the remainder.  The treatment was conservative surgery in 13 patients associated with topical chemotherapy based on mitomycin C either adjuvant or neoadjuvant, 3 patients underwent total orbital exenteration following a locoregional invasion. The patients are regularly followed in our training only one case of limbic insufficiency following local chemotherapy was observed, 2 patients presented a local recurrence, no patient died of his disease during the observation period.

A biopsy-excision of any suspicious lesion is the best way to confirm the diagnosis. As well as the systematic analysis of pterygium excisional parts makes it possible not to ignore conjunctival neoplasia, of which we know the variability of the initial clinical pictures. The early diagnosis improves the prognosis.