Can You Guess March's Mystery Condition?
Make your diagnosis in the comments, and look for the answer in next month’s Blink.
Last Month’s Blink
PFO After Vitreoretinal Surgery
Written by Anchal Thakur, MBBS, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India. Photo by Anchal Thakur, MBBS, and Amit Gupta, MD, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
An 85-year-old man presented with a leukoplakic conjunctival mass in the temporal aspect of the left eye that had been there for 10 months. The mass was encroaching onto the cornea. No significant inflammation or dilated feeder vessels were present. Clinical diagnosis of leukoplakic ocular surface squamous neoplasia (OSSN) was made.1 The mass was surgically excised along with 4 mm of healthy conjunctiva, with cryotherapy at the margins.2 Histopathology of the mass showed microabscess formation in the conjunctival epithelium with moderate lymphonuclear infiltration and a few foci of moderate dysplasia.3 Scattered fungal profiles were seen in the superficial layers of the mass on H & E, and Grocott’s methenamine silver stains confirmed the diagnosis of conjunctival mycosis4,5 along with carcinoma in situ. This is the first report of leokoplakic OSSN with fungal colonization, an extremely rare co-occurrence.
1 Krachmer JH et al. Cornea: Fundamentals, Diagnosis and Management. St. Louis, Mo.: Mosby Elsevier; 2005.
2 Reidy JJ et al. Basic and Clinical Science Course, 2011-2012. San Francisco: American Academy of Ophthalmology; 2011.
3 McKelvie PA et al. Br J Ophthalmol. 2002;86(2):168-173.
4 Sehgal SC et al. Mycopathologia. 1981;73(1):17-19.
5 Ando N, Takatori K. Am J Ophthalmol. 1982;94(1):67-74.
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