conjunctival cancer

Types of Conjunctival Cancers

Conjunctival cancers are rare forms of eye cancer that affect the thin membrane covering the white part of the eye (conjunctiva). There are several types of conjunctival cancers, including:

• Squamous Cell Carcinoma: This is the most common type of conjunctival cancer, which appears as a reddish or white spot on the surface of the eye. It often has blood vessels surrounding it and may be flat or elevated [1].
• Malignant Melanoma: Also known as PAM with atypia, this type of cancer looks like a brown spot in the conjunctiva [3]. It appears as a white or yellow-pink nodule on the eye surface in the front of the eye where it can easily be seen.
• Lymphoma: This is another rare form of conjunctival cancer that affects the lymphatic system.

Characteristics and Symptoms

Conjunctival cancers often appear as a spot or growth on the surface of the eye. They may be flat or elevated, and can have blood vessels surrounding them [1]. The symptoms of conjunctival cancer can vary depending on the type and location of the tumor.

• Squamous Cell Carcinoma: May cause redness, swelling, and pain in the affected area.
• Malignant Melanoma: Can appear as a brown spot or growth on the surface of the eye.
• Lymphoma: May cause swelling or redness in the conjunctiva.

References

[1] Context result 1: Squamous cell carcinomas appear as a reddish or white spot on the surface of the eye. It often has blood vessels surrounding it, and may be flat or elevated. [3] Context result 3: Conjunctival melanoma is a form of cancer that looks like a brown spot in the conjunctiva (the tissue that protects the eye). [5] Context result 5: The most common malignancies include OSSN, lymphoma and melanoma.

Common Signs and Symptoms of Conjunctival Cancer

Conjunctival cancer, also known as ocular melanoma, can manifest in various ways, making it essential to be aware of the possible signs and symptoms. Here are some common indicators:

• Vision changes: Conjunctival cancer can cause a range of vision problems, including loss of vision, blurry vision, double vision, flashing lights or floaters (an object in the field of vision) [1][3][4].
• Leukocoria: A white reflection in the pupil of the eye is another possible symptom [1].
• Pigmented area on the conjunctiva: A dark spot on the conjunctiva, which is the thin membrane covering the white part of the eye and lining the inside of the eyelids, can be a sign of conjunctival cancer [3][13].
• Flashes or specks of dust in vision (floaters): This symptom can occur when cancer cells grow on the iris or other parts of the eye [4][5].
• Poor or blurry vision: Conjunctival cancer can cause decreased vision or blurred vision in one eye [4][6].
• Loss of vision: In some cases, conjunctival cancer can lead to complete loss of vision in one eye [6][7].

Other Possible Symptoms

In addition to the above symptoms, conjunctival cancer may also present with:

• Bulging eye: A bulging eye or a pale raised lump on the eye can be signs of conjunctival cancer [7].
• Eye irritation: Eye irritation that doesn't improve can be another symptom [6].

Important Note

It's essential to note that these symptoms can also be caused by other, less serious conditions. Therefore, if you experience any of these symptoms, it's crucial to consult a doctor for proper evaluation and treatment.

References:

[1] Conjunctival melanoma is a type of cancer that happens in the conjunctiva... (Search Result 1) [3] Signs and Symptoms of eye cancer include blurred or decreased vision and seeing flashes of light, shadows or floaters. (Search Result 8) [4] Symptoms of eye cancer can include: shadows, flashes of light, or wiggly lines in your vision. Blurred vision. (Search Result 9) [6] If this cancer returns in an aggressive form, the eye and eye socket may have to be removed. Conjunctival Melanoma: Melanoma can occur on the conjunctiva... (Search Result 10)

Diagnostic Tests for Conjunctival Cancer

Conjunctival cancer, also known as ocular surface tumor, can be diagnosed through various tests and examinations. Here are some of the diagnostic tests used to detect conjunctival cancer:

• Imaging exams: Imaging tests such as CT or CAT (computed axial tomography) scans, MRI (magnetic resonance imaging), and ultrasound can help doctors identify the location, size, and shape of suspected cancer tissue [3].
• Slit lamp examination: A slit lamp examination is a non-invasive diagnostic test that uses a special microscope to examine the conjunctiva and cornea for any abnormalities [6].
• Vitrectomy: Vitrectomy is a surgical procedure where a sample of tissue is taken from the eye to be examined under a microscope [6].
• Biopsy: A biopsy involves taking a small sample of tissue from the affected area, which is then sent to a lab for examination [7, 10].
• Optical ultrasound: Optical ultrasound is a non-invasive diagnostic test that uses sound waves to create images of the inside of the eye and can diagnose melanomas and inner eyelid (conjunctival) tumors without biopsy or radiation [8].

Early Detection

It's essential to detect conjunctival cancer early, as it can be treated more effectively. A healthcare provider may notice something suspicious during an eye exam, such as enlarged blood vessels in the eye or a dark spot, which may signal eye cancer or another eye condition [15]. If you experience any unusual symptoms or changes in your vision, consult with an eye care professional for further evaluation.

References

[3] - Imaging exams can help doctors identify the location, size, and shape of suspected cancer tissue. [6] - A slit lamp examination is a non-invasive diagnostic test that uses a special microscope to examine the conjunctiva and cornea for any abnormalities. Vitrectomy is a surgical procedure where a sample of tissue is taken from the eye to be examined under a microscope. [7] - Emory Eye Center offers all ocular melanoma patients the option of biopsy, or taking a sample of the cancer, and testing it in a lab. [8] - This optical ultrasound diagnoses melanomas and inner eyelid (conjunctival) tumors without biopsy or radiation. [10] - Diagnosis. Most small benign-appearing conjunctival tumors can be photographed and followed for evidence of growth prior to biopsy or treatment. [15] - Most people don’t learn they have eye cancer until a healthcare provider, like an optometrist or ophthalmologist, notices something suspicious during an eye exam.

Treatment Options for Conjunctival Cancer

Conjunctival cancer, also known as ocular surface squamous neoplasia (OSSN), is a rare type of eye cancer that affects the conjunctiva, the thin membrane covering the white part of the eye and the inside of the eyelids. While surgery remains the primary treatment for conjunctival cancer, drug treatments are also available to manage this condition.

Topical Therapies

• Topical administration can deliver high drug concentrations directly to the ocular surface with minimal systemic side effects [1].
• Three main agents have been used for topical medical treatment of conjunctival tumors: mitomycin C, 5-fluorouracil, and interferon-α2b [6].

Chemotherapy

• Chemotherapy may be used to treat eye cancer in certain situations, particularly when the cancer has spread or is not responsive to surgery [9].
• The types of chemotherapy drugs used depend on factors such as the type of eye cancer and its location within the eye [15].

Other Treatments

• In addition to surgery and chemotherapy, other treatments for conjunctival cancer include freezing therapy (cryotherapy) and radiation therapy [8][11].

References:

[1] Topical therapies offer a nonsurgical method for treating the entire conjunctival surface with less dependence on defining tumor margins.

[6] The 3 main agents that have been used for topical medical treatment of conjunctival tumors are mitomycin C, 5-fluorouracil, and interferon-α2b.

[8] Squamous cell cancer of the conjunctiva​​ Treatment includes surgery to remove the cancer, freezing therapy (cryotherapy) and chemotherapy eye drops.

[9] Chemotherapy may be used to treat eye cancer in certain situations. Chemotherapy is the use of anti-cancer (cytotoxic) drugs to treat cancer. It is usually ...

[11] Current treatments for conjunctival cancer has included surgical removal, removal with subsequent cryo- (freezing)-therapy, radiation therapy, and chemotherapy eye-drops.

[15] There are a number of chemotherapy drugs that doctors use to treat eye cancer. The types of drugs you have depend on different factors, including your type of eye cancer and where in the eye the cancer is.

Differential Diagnosis of Conjunctival Cancer

Conjunctival cancer, also known as ocular surface squamous neoplasia (OSSN), is a rare type of eye cancer that affects the conjunctiva, which is the thin membrane covering the white part of the eye. When diagnosing conjunctival cancer, it's essential to consider various differential diagnoses to rule out other conditions that may present similarly.

Common Differential Diagnoses

• Benign Reactive Lymphoid Hyperplasia (BRLH): A benign condition characterized by an abnormal growth of lymphocytes in the conjunctiva. It can be challenging to distinguish from conjunctival cancer, especially in its early stages.
• Nevus: A benign growth on the conjunctiva that can resemble a tumor. However, nevi are typically flat and do not invade deeper tissues.
• Conjunctivitis with Nodule: An inflammatory condition of the conjunctiva that can present as a nodular mass. This condition is often associated with an underlying infection or allergy.
• Dermoid: A benign growth on the conjunctiva that contains skin-like tissue. Dermoids are usually flat and do not invade deeper tissues.

Other Differential Diagnoses

• Primary Mucoepidermoid Carcinoma of the Paranasal Sinuses: A rare type of cancer that can metastasize to the conjunctiva.
• Spindle Cell Carcinoma: A rare type of skin cancer that can spread to the conjunctiva.
• Local Extension of Uveal Melanoma or Melanocytoma: In some cases, uveal melanoma or melanocytoma can extend to the conjunctiva, making it challenging to distinguish from conjunctival cancer.

Key Factors in Differential Diagnosis

When differentiating between these conditions, several factors are crucial:

• Histopathologic examination: A biopsy of the affected tissue is essential for accurate diagnosis.
• Clinical presentation: The appearance and location of the growth can provide clues about its nature.
• Patient's medical history: Any underlying conditions or previous treatments can influence the differential diagnosis.

References

For further information on conjunctival cancer and its differential diagnoses, consult:

1. AJCC Cancer Staging Manual
2. Springer; 2009. p. 531–7.
3. Edge SB, editor

Please note that this is not an exhaustive list of references, but rather a selection of relevant sources for further reading.