DR. NEHA ARORA

DR. STEPHEN SUDHAKAR

Abstract

23-year-old man presented with tissue growth in left eye for 2 months. He was a known case of Autoimmune Polyglandular Syndrome type 3 since age of 5 with Autoimmune Hemolytic anemia, Primary Hypothyroidism and Primary Hypogonadism. He was treated with long term oral steroids and Azathioprine for 18 years. Left eye examination showed 8 x 5mm fleshy non-ulcerated lesion on nasal conjunctiva extending 3mm into cornea with corneal scarring and brown pigmentation along superior border. Remaining ocular examination normal with OU Vision 6/6 N6. UBM showed mass invading posterior cornea and deep sclera, including limbus. Incisional biopsy of lesion showed Conjunctival Squamous cell carcinoma in-situ. Patient was advised aggressive treatment of OSSN with Wide local excision; however, he did not consent to surgery. He was thus treated with topical Mitomycin C 0.04%, and remains on close follow-up. We postulate that carcinogenesis could have arisen as a result of chronic use of Azathioprine.