Ocular Surface Squamous Neoplasia Masquerading As Psuedoepitheliomatous Hyperplasia In Chronic Vernal Keratoconjunctivitis

To report a case of ocular surface squamous neoplasia (OSSN) masquerading as psuedoepitheliomatous hyperplasia (PEH) in  a patient with chronic Vernal keratoconjunctivitis (VKC)

Tertiary eye care centre in India

We report a case of ocular surface squamous neoplasia (OSSN) masquerading as psuedoepitheliomatous hyperplasia (PEH) in chronic Vernal keratoconjunctivitis (VKC). A 24 years old gentleman presented with history of bilateral vernal keratoconjunctivitis since childhood with superior limbus mass in right eye,with use of intermittent corticosteroids in past.He underwent impression cytology (IC) followed by excision biopsy (no touch technique) with wide margins ,cryotherapy and amniotic membrane transplantation.Histopathological (HPE) analysis confirmed the diagnosis of OSSN with mild to moderate dysplasia. This is the first reported case of OSSN masquerading as PEH to the best of our knowledge. This highlights the  importance of strong clinical suspicion and detailed cytological and histopathological examination for early detection and management of OSSN.

Squamous lesions of the cornea and conjunctiva are uncommon but demand appropriate attention due to the potential for visual loss and systemic morbidity and mortality. Excellent results can be achieved by early detection, investigations, followed by meticulous surgery and regular follow up of the patient. This is the first reported case of OSSN masquerading as PEH to the best of our knowledge, highlighting the  importance of strong clinical suspicion and detailed cytological and histopathological examination for early diagnosis and management of OSSN