Corneal conjunctival tumor in a patient with HIV infection. A case report.

Abstract

Pterygium is a degenerative fibrovascular growth with a triangular morphology that shares some features with neoplasias, so a differential diagnosis must be made. Ocular surface squamous cell neoplasia (OSSN) covers a spectrum that includes conjunctival intraepithelial neoplastic lesions (CIN) and invasive squamous cell carcinoma of the conjunctiva and cornea. There is a high incidence of OSSN in patients with HIV infection. Objective: To describe the clinical case of a female patient with a conjunctival-corneal tumor and HIV infection. Methods: We present the case of a 54-year-old female patient who reports a 4 year history of a lesion in the left eye of the bulbar conjunctiva in the nasal sector that invades the peripheral, paracentral and central cornea. It was white-gray with a soft gelatinous consistency of 8x5 mm, vascularized, with defined edges; The patient also has a history of HIV diagnosed 20 years ago, currently on treatment with atazanavir, ritonavir, zidovudine + lamivudine, with no ophthalmological history. Diagnosed with connective tissue-corneal tumor in the left eye, senile cataract in the right eye. An excisional biopsy with wide margins of the connective tissue-corneal tumor in the left eye was performed using the “no touch” technique and with intraoperative treatment with mitomycin C at 0.02%. Results: the biopsy reported conjunctival intraepithelial neoplasia 1/mild dysplasia (confined to the basal third of the conjunctival epithelium) with negative surgical margins. After excision, the patient achieved improvement in VA in the left eye 20/100. Conclusions: the definitive diagnosis of OSSN should be confirmed by a biopsy of the connective tissue-corneal tissue. The treatment of non extensive localized lesions is complete surgical resection of the tumor and non-surgical therapies