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Squamous Cell Carcinoma of Medial Canthal Skin with Perineural Invasion of Orbit Mary Mercer, M.D.*, Ilya Leyngold, M.D.*, and Curtis E. Margo, M.D., M.P.H.*† *Department of Ophthalmology, and †Pathology and Cell Biology, Morsani College of Medicine, University of South Florida, Tampa, Florida, U.S.A.
FIG. 1. No lesion was visible or palpable in medial canthal skin, where 3 months earlier a skin tumor had been “frozen.”
FIG. 2. Axial CT image showing soft tissue mass involving mostly medial rectus muscle from the region posterior to the eye to the orbital apex.
A
FIG. 3. Squamous cell carcinoma surrounds magenta-colored peripheral nerves in this cross section of medial rectus muscle. Perineural tumor could be traced within muscle from the proximity of the globe to the apex of the orbit (periodic acid-Schiff; bar = 400 microns). Inset A cytokeratin stains highlights perineural tumor (bar = 140 microns).
Accepted for publication May 2, 2015. The authors have no financial or conflict of interest to disclose. Address correspondence and reprint requests to Curtis E. Margo, M.D., M.P.H., Department of Ophthalmology, Morsani College of Medicine, University of South Florida, 12901 Bruce B. Downs Blvd., Tampa, FL 33612. E-mail:[email protected] DOI: 10.1097/IOP.0000000000000516
as pain and diplopia progressed. The scan was normal. Eleven months after initial cryotherapy another CT scan revealed a mass in the right posterior orbit (Fig. 2). Biopsy and then orbital exenteration showed squamous cell carcinoma with extensive perineural invasion extending from the belly of the medial rectus muscle to orbital apex (Fig. 3). An extensive systemic evaluation found no evidence of carcinoma elsewhere. The patient died several months later from complications of intracranial spread.
n 80-year-old man presented with right medial orbit pain 3 months after having a suspected squamous cell carcinoma of the right medial canthus “frozen.” The skin in this area appeared normal (Fig. 1) and a biopsy showed chronic inflammation and mild scarring. A CT of the orbit was obtained several months later
e50
Ophthal Plast Reconstr Surg, Vol. 32, No. 2, 2016
Copyright © 2014 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc. Unauthorized reproduction of this article is prohibited.
Squamous Cell Carcinoma of Medial Canthal Skin with Perineural Invasion of Orbit Mary Mercer, M.D.*, Ilya Leyngold, M.D.*, and Curtis E. Margo, M.D., M.P.H.*† *Department of Ophthalmology, and †Pathology and Cell Biology, Morsani College of Medicine, University of South Florida, Tampa, Florida, U.S.A.
FIG. 1. No lesion was visible or palpable in medial canthal skin, where 3 months earlier a skin tumor had been “frozen.”
FIG. 2. Axial CT image showing soft tissue mass involving mostly medial rectus muscle from the region posterior to the eye to the orbital apex.
A
FIG. 3. Squamous cell carcinoma surrounds magenta-colored peripheral nerves in this cross section of medial rectus muscle. Perineural tumor could be traced within muscle from the proximity of the globe to the apex of the orbit (periodic acid-Schiff; bar = 400 microns). Inset A cytokeratin stains highlights perineural tumor (bar = 140 microns).
Accepted for publication May 2, 2015. The authors have no financial or conflict of interest to disclose. Address correspondence and reprint requests to Curtis E. Margo, M.D., M.P.H., Department of Ophthalmology, Morsani College of Medicine, University of South Florida, 12901 Bruce B. Downs Blvd., Tampa, FL 33612. E-mail:[email protected] DOI: 10.1097/IOP.0000000000000516
as pain and diplopia progressed. The scan was normal. Eleven months after initial cryotherapy another CT scan revealed a mass in the right posterior orbit (Fig. 2). Biopsy and then orbital exenteration showed squamous cell carcinoma with extensive perineural invasion extending from the belly of the medial rectus muscle to orbital apex (Fig. 3). An extensive systemic evaluation found no evidence of carcinoma elsewhere. The patient died several months later from complications of intracranial spread.
n 80-year-old man presented with right medial orbit pain 3 months after having a suspected squamous cell carcinoma of the right medial canthus “frozen.” The skin in this area appeared normal (Fig. 1) and a biopsy showed chronic inflammation and mild scarring. A CT of the orbit was obtained several months later
e50
Ophthal Plast Reconstr Surg, Vol. 32, No. 2, 2016
Copyright © 2014 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc. Unauthorized reproduction of this article is prohibited.
