Conjunctival keratoacanthoma

Abstract

Keratoacanthoma generally occurs on the skin; it is rarely found in the conjunctiva. A case of a 34-year-old woman with a rapidly growing conjunctival mass is reported. The tumor was excised with a safety margin to exclude squamous cell carcinoma. Histopathologically it was crateriform and consistent with atypical keratoacanthoma. There has been no recurrence in 2 years of follow-up. Conjunctival keratoacanthoma is rare; differential diagnosis of conventional squamous cell carcinoma and keratoacanthoma can be difficult. We recommend complete surgical excision and careful follow-up of crateriform squamous proliferations.

Keratoacanthoma of the conjunctiva in a young patient

“…Most of the documented cases have been found on the temporal bulbar conjunctiva within the palpebral aperture and adjacent to the limbus. However, in our patient, the KA formed on the nasal conjunctiva, which was similar to cases reported by Perdigao et al (6) and Chowdhury et al (8) . A male predominance was observed in previously reported cases, and our patient was also male.…”

“…The first case of conjunctival KA was described by Freeman et al (4) , and only a few cases have been described to date (5)(6)(7) . Most of the documented cases have been found on the temporal bulbar conjunctiva within the palpebral aperture and adjacent to the limbus.…”

Keratoacanthoma: a tumor in search of a classification

“…The peak incidence of solitary KA occurs between the ages of 50 and 69 years; 1 however, KA has been reported in all age groups, 11–14 with some cases in children, but it remains unusual in patients younger than 20 years of age 11 . Its incidence increases with age.…”

“…Instead, there is peripheral extension with a raised border, and atrophy in the center of the lesion 9,44 . Other rare forms of KA include conjunctival 14 and vulvar 60 KA.…”

Spontaneous regression of conjunctival keratoacanthoma

“…Common risk factors include history of ultraviolet exposure, history of cutaneous KAs and skin conditions such as xeroderma pigmentosa 3 4. The first case of a conjunctival KA was reported by Friedman et al in 1965,3 and there have been less than 20 subsequent reports of this entity 2–15. To our knowledge, there have not been any prior reports documenting the partial, spontaneous regression of a conjunctional KA.…”