A 24-year-old woman presented with a 10-day history of dark-colored lesion in the internal area of her left eye.
The patient assured the recent appearance and a progressive increase in size.
There were no associated symptoms, personal history of interest or any treatment.
Visual acuity in both eyes was the unit with its correction.
Biopsy revealed a dark pigmented lesion of homogeneous brownish color, with minimal surface area and cystic areas in the interior of the caruncle of the left eye, 2×3mm apart.
The right eye and the rest of the exploration were normal.
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Due to the rapid appearance and evolution of the lesion, a complete excision of the conjunctival lesion with a free margin of 5 mm around was performed, preserving the tenon and sclera, without pigmented lesions.
After surgery the reepithelialization was complete at two weeks and the patient is currently asymptomatic.
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Pathological anatomy revealed necrotic squamous cell carcinoma composed of surgical margins free of lesion.
The microscopic study showed great cellular heterogenicity, with neocytes in different degrees of maturation, amorphous cells with dislocated nucleus, changes in the nucleus-cytoplasm ratio of the cells, irregular pigmentation in the whole cell.
The immunohistochemical study showed positivity for Melan-A, negativity for HMB-45 and positive groupings of medulla CD68 which corresponded to the most irregular cells of large size observed in the study.
