IJCRR - 8(24), December, 2016
CASE REPORT OF SPINDLE CELL CARCINOMA OF THE CONJUNCTIVA- A RARE TUMOUR
Author: Mehulkumar K. Patel, Sanjay V. Dhotre, Mahesh B. Patel, Hansa M. Goswami, Hitendra P. Barot, Monika S. Nanavati
Aim: To present a case of spindle cell carcinoma of the conjunctiva to emphasize the importance of detailed pathological examination to differentiate the cell type for the prognosis and the decision of proper treatment.
Case Report: A 55 year old male patient presented at civil hospital, Ahmedabad with complain of decreased vision in the left eye. There was no history of trauma and pain. On examination, a pedunculated lesion over the conjunctiva with no ulceration, which grew slowly over 4 months. Histopathological examination showshistology of poorly differentiated squamous cell carcinoma of the conjunctiva with sarcomatoid differentiation (spindle cell variant of squamous cell carcinoma) which was confirmed on subsequent immunohistochemical examination.
Discussion: Squamous cell carcinoma is the most common malignant tumor of the ocular surface8. Spindle cell carcinoma is a poorly differentiated variant of squamous cell carcinoma that rarely occurs in the conjunctiva 3,4,5,6,7. Cervantes et al. reported a total 287 cases of squamous cell carcinoma of conjunctiva, in which only two cases were documented as spindle cell carcinoma11. Surgical excision with or without cryotherapy and radiotherapy remains widely accepted treatment for squamous cell carcinoma of the conjunctiva9,10.
Conclusion: Because of their possible aggressive behaviour, spindle cell carcinoma of the conjunctiva is known to be sight- and life threatening. It is important to differentiate this variety of squamous cell carcinoma from mimics specially sarcomas with spindle cell morphology and spindle cell predominant malignant melanoma. Hence detailed pathological examination is very important to differentiate the cell type for the prognosis and the decision of proper treatment.
Keywords: Conjunctiva, Spindle cell carcinoma, Immunohistochemical examination
Mehulkumar K. Patel, Sanjay V. Dhotre, Mahesh B. Patel, Hansa M. Goswami, Hitendra P. Barot, Monika S. Nanavati. CASE REPORT OF SPINDLE CELL CARCINOMA OF THE CONJUNCTIVA- A RARE TUMOUR International Journal of Current Research and Review. 8(24), December, 51-53
1. Zheng Y, Xiao M, Tang J. clinicopathological and immunohistochemical analysis of spindle cell carcinoma of larynx or hypopharynx: A report of three cases. Oncol Lett. 2014;8:748-52.
2. Torenbeek R, Hermsen MA, Meijer GA, Baak JP, Meijer CJ. Analysis by comparative genomic hybridization of epithelial and spindle cell components in sarcomatoid carcinoma and carcinosarcoma: Histogenetic aspects. J Pathol. 1999;189:338-43.
3. Cohen BH, Green WR, Iliff NT, Taxy JB, Schwab LT, de la Cruz Z. Spindle cell carcinoma of the conjunctiva. Arch Ophthalmol 1980;98:1809-13.
4. Huntington AC, Langloss JM, Hidayat AA. Spindle cell carcinoma of the conjunctiva. An immunohistochemical and ultrastructural study of six cases. Ophthalmology. 990;97:711-7.
5. Ni C, Guo BK, histological types of spindle cell carcinoma of cornea and conjunctiva. A clinicopathologic report of 8 patients with ultrastructural and immunohistochemical findings in three tumors. Chin Med J (Engl) 1990;103:915-20.
6. Schubert HD, Farris RL, Green WR. Spindle cell carcinoma of the conjunctiva. Graefes Arch Clin Exp Ophthalmol. 1995;233:52-3.
7. Slusker-Shternfeld I, Syed NA, Sires BA, Invasive spindle cell carcinoma of the conjunctiva. Arch Ophthalmol. 1997;115:288-9.
8. Sun EC, Fears TR, Goedert JJ, Epidemiology of squamous cell conjunctival cancer. Cancer Epidemiol Biomarkers Prev. 1997;6:73-7.
9. Shields CL, Shields JA, Tumors of the conjunctiva and cornea. Surv Ophthalmol. 2004;49:3-24.
10. Miller CV, Wolf A, Klingenstein A, Decker C, Garip A, Kampik A, et al. Clinical outcome of advanced squamous cell carcinoma of the conjunctiva. Eye (Lond) 2014;28: 962-7.
11. Cervantes G, Rodriguez AA Jr, Leal AG, squamous cell carcinoma of the conjunctiva: Clinicopathological features in 287 cases. Can J Ophthalmol. 2002;37:14-9