Conjunctival ‘mucoepidermoid carcinoma’ revisited: a revision of terminology, based on morphologic, immunohistochemical and molecular findings of 14 cases, and the 2018 WHO Classification of Tumours of the Eye

Conjunctival squamous intraepithelial neoplasia and its differential diagnosis

“…The term actinic keratosis has been applied to dysplasia with parakeratosis and keratinisation, but its use in this context can be confusing and has not been promoted 1 7. The presence of intracellular mucin detected by Alcian blue and periodic acid–Schiff with diastase staining supports the diagnosis of the in situ phase of adenosquamous carcinoma, an aggressive variant of conjunctival squamous cell carcinoma (previously referred to as mucoepidermoid carcinoma) 8–11…”

“…Conjunctival squamous cell carcinoma is locally invasive and rarely metastasises 1 2 7. Among the variants of conjunctival squamous cell carcinoma, adenosquamous carcinoma (previously mucoepidermoid carcinoma) poses the greatest risk of intraocular invasion 9–11…”

The 5th Edition of the World Health Organization Classification of Tumours of the Eye and Orbit

“…The term adenosquamous carcinoma, introduced in the Eye4 as the preferred term for mucoepidermoid carcinoma, is now recommended to be applied only to neoplasms with bi-phenotypic differentiation comprising squamous cell carcinoma and adenocarcinoma with mucin-containing cells (shown in Fig. 2) [2, 30]. Tumors that do not form true neoplastic glands/ducts or confluent sheets of cells with intracytoplasmic mucin and, instead, show scattered or small clusters of cells with such mucin in a background of malignant squamous cells are designated as “squamous cell carcinoma with mucinous differentiation” (shown in Fig.…”

“…Tumors that do not form true neoplastic glands/ducts or confluent sheets of cells with intracytoplasmic mucin and, instead, show scattered or small clusters of cells with such mucin in a background of malignant squamous cells are designated as “squamous cell carcinoma with mucinous differentiation” (shown in Fig. 3) [2, 30]. Sebaceous carcinoma, covered in Tumors of the Eyelid chapter, has been removed.…”

Iodine-125 plaque brachytherapy for aggressive squamous cell carcinoma with corneal and scleral invasion

“…The absence of BerEP4 immunoreactivity in the lesion made adenosquamous carcinoma less likely. [ 1 ] The patient underwent Iodine- 125 (125 I) plaque brachytherapy, utilizing conjunctival/scleral fixation of a 16 mm plaque to a depth of 1.6 mm, delivering 60 Gy. The plaque was removed 1 week later.…”