Giant keratoconjunctival papilloma: A case report

Background: Squamous cell carcinoma (SCC) is the most frequently diagnosed malignant tumor in the conjunctiva. It is often difficult to distinguish SCC from conjunctival papilloma clinically. We report a case of keratoconjunctival papilloma that presented as a very large mass and was difficult to differentiate from SCC. Case Report: The patient was a 72-year-old male with a conjunctival tumor that over several months had extended to the nasal cornea of his right eye. He consulted a local ophthalmologist, who referred the patient to Department of Ophthalmology, Tohoku University Hospital for diagnosis and surgical removal of the tumor. On initial examination in our department, we noted a grey-white tumor in the right eye that measured about 16×13 mm and was abundantly supplied with blood vessels. The tumor extended from the fornix to the cornea between 11 o'clock and 5 o'clock. We removed the tumor and performed cryopexy at the edge of the bulbar conjunctiva and amnion membrane transplantation. The histological diagnosis was conjunctival papilloma. The tumor has not recurred. Conclusions: We report a case of giant conjunctival squamous cell papilloma that was misdiagnosed clinically as SCC. Careful evaluation is needed to make the differential diagnosis between conjunctival squamous cell papilloma and SCC involving the conjunctiva.