We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Ophthalmic Images |

Regression of Squamous Cell Carcinoma With Corneal Invasion Following Local Resection and Plaque Radiotherapy Online Only

Cameron Lee, BA1; Sara E. Lally, MD1; Carol L. Shields, MD1
[+] Author Affiliations
1Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania
JAMA Ophthalmol. 2016;134(8):e161009. doi:10.1001/jamaophthalmol.2016.1009.
Text Size: A A A
Published online


This case report describes a white man in his late 70s who noticed a white mass on his right eye that grew larger over 5 months.

A white man in his late 70s noticed a white mass on his right eye that grew larger over 5 months. At presentation, his visual acuity was 20/25 OD, and an examination revealed a pink-white limbal mass temporally with dilated feeder vessels, minimal leukoplakia, and extensive corneal stromal infiltration with feathery margins (Figure, A). Ultrasound biomicroscopy demonstrated increased corneal thickness with hyperechogenicity and posterior bulging into the anterior chamber, suggesting solid tumor invasion. Based on the presumptive diagnosis of corneal-invasive squamous cell carcinoma of the conjunctiva, the management strategy included alcohol superficial keratectomy, wide surgical resection of conjunctival component using a “no touch” technique, and cryotherapy to conjunctival margins with conjunctival reconstruction.1 The corneal-infiltrative stromal component was managed with iodine 125 plaque radiotherapy directly over the affected corneal surface and adjacent sclera, designed to irradiate for a 3-mm depth.2,3 On follow-up, complete regression of both conjunctival and corneal-invasive malignancy was observed (Figure, B). Visual acuity remained 20/25 OD.

Figures in this Article


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption

A, Conjunctival squamous cell carcinoma with invasion into the corneal stroma, confirmed by ultrasound biomicroscopy, was managed with “no touch” surgical resection and brachytherapy. B, On follow-up, complete tumor regression was documented clinically and ultrasonographically.

Graphic Jump Location




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.