case_images: PMC11257755_01
case_images: (a, b) An 8.5 x 8.0 mm elevated pedunculated, fibrovascular, fleshy mass at the superonasal limbus encroaching the cornea.
case_images: CRIOPM2024-3113342.001.jpg
case_images: PMC11257755_01_CRIOPM2024-3113342.001.jpg
case_images: fig1
case_images: On examination, an 8.5 mm x 8.0 mm elevated, pedunculated, fibrovascular, fleshy mass at the superonasal limbus encroaching on the cornea of the right eye was observed (Figure 1). The surface of the lesion was irregular, with adherent whitish-to-grayish plaques typically seen in OSSN (Figure 1, arrow). Several feeder vessels surrounding the lesion can also be observed (Figure 1(b)).
case_images: Microscopic section stained with H&E showing sheets of irregular papillae lined by basaloid cells arranged in peripheral palisading pattern. (a) Scanner view shows thickening of the epithelium with dysplastic cells occupying the full thickness of the conjunctival epithelium with nests of tumor cells extending to the underlying stroma (arrow) and an underlying solar elastosis (arrowhead). (b) LPO view showing lesions exhibiting papillary configuration in peripheral palisading pattern with intralesional fibrovascular core (*) and are as of necrosis (arrowhead). (c) HPO view showing lesions exhibiting papillary configuration in peripheral palisading pattern with intralesional fibrovascular core (arrow).
case_images: CRIOPM2024-3113342.002.jpg
case_images: PMC11257755_01_CRIOPM2024-3113342.002.jpg
case_images: fig2
case_images: Microscopically, basaloid cells with peripheral palisading were observed, consistent with BCC (Figures 2(a), 2(b), and 2(c)).
case_images: HPO view of (a) BCL2, (b) CD10, (c) EMA, and (d) CEA immunohistochemical stains. Positivity for BCL2 and CD10 stains was confirmed by the brown color of the neoplastic cells. EMA and CEA show negative expression on neoplastic cells.
case_images: CRIOPM2024-3113342.003.jpg
case_images: PMC11257755_01_CRIOPM2024-3113342.003.jpg
case_images: fig3
case_images: Immunohistochemistry was requested for confirmatory testing, which revealed positive Bcl-2 and CD10 markers (Figures 3(a) and 3(b)) and negative epithelial membrane antigen (EMA) and carcinoembryonic antigen (CEA) markers (Figures 3(c) and 3(d)).
case_images: The patient at 8 weeks post excision of the conjunctival mass showing regrowth of the fibrovascular mass.
case_images: CRIOPM2024-3113342.004.jpg
case_images: PMC11257755_01_CRIOPM2024-3113342.004.jpg
case_images: fig4
case_images: Fibrovascular tissue proliferation near the nasal limbus was noted at 8 weeks postoperatively, indicating possible recurrence (Figure 4).
case_images: Anterior segment OCT of the recurrence of the conjunctival mass showing a hyperreflective band continuous with the conjunctival epithelium.
case_images: CRIOPM2024-3113342.005.jpg
case_images: PMC11257755_01_CRIOPM2024-3113342.005.jpg
case_images: fig5
case_images: A hyperreflective band of the conjunctival mass that was continuous with the epithelium was noted (Figure 5).
case_images: No recurrence noted at 6 months postoperatively.
case_images: CRIOPM2024-3113342.006.jpg
case_images: PMC11257755_01_CRIOPM2024-3113342.006.jpg
case_images: fig6
case_images: No recurrence was noted 16 months postoperatively (Figure 6).