Adeno Squamous Palpebral Carcinome with Orbitary Extension: Case Report

Case Report

Austin J Clin Ophthalmol. 2021; 8(1): 1116.

Adeno Squamous Palpebral Carcinome with Orbitary Extension: Case Report

Imad L*, Naya K, Hasnaoui I, Abdellah E and Berraho A

Department of Ophthalmology B, Ibn Sina Hospital, University Mohamed V, Rabat, Morocco

*Corresponding author: Lidya Imad, Department of Ophthalmology B, Ibn Sina Hospital, University Mohamed V, Rabat, Morocco

Received: April 07, 2021; Accepted: May 01, 2021; Published: May 08, 2021

Abstract

Adeno-Squamous Carcinoma (ASC) is a neoplastic variety characterized histologically by the presence of 2 distinct carcinomatous contingents, adenomatous and squamous.

This tumor form is extremely rare, and even more so in its palpebral localization.

In the light of this observation, we will expose the anatomo-clinical and evolutionary peculiarities of this uncommon variant.

Keywords: Adeno-squamous Carcinoma; Eyelid; Orbitary extension; Exenteration

Case Presentation

This 27-year-old presents with a left internal canthal swelling, increasing in volume over the last 5 months.

The ophthalmologic examination finds a left internal canthal ulcer-burgeoning process extending over the internal 1/3 of the lower eyelid with inflammatory signs; the rest of the examination is normal [1-3].

Figure 1: Superinfected ulcerous budding tumor of the left internal cantus.

    

    
    

    

    Figure 1: Superinfected ulcerous budding tumor of the left internal cantus.

Figure 2-3: Tumor proliferation with cells in clumps with squamous differentiation, and others arranged around glandular slits.

    

    
    

    

    Figure 2-3: Tumor proliferation with cells in clumps with squamous
differentiation, and others arranged around glandular slits.

Figure 4: Orofacial CT scan: left medial canthal tissue process extending into the nasolacrimal duct.

    

    
    

    

    Figure 4: Orofacial CT scan: left medial canthal tissue process extending into
the nasolacrimal duct.

Figure 5: Exenteration with osteotomies on the nasolacrimal duct and nasal cavity.

    

    
    

    

    Figure 5: Exenteration with osteotomies on the nasolacrimal duct and nasal cavity.

Tumor biopsy with anatomo-pathological study confirms the diagnosis of well-differentiated adeno-squamous carcinoma [4].

Orbital-facial CT scan reveals a left internal canthal tissue process extending into the nasolacrimal duct.

The patient benefited from Exenteration with osteotomies on the nasolacrimal duct and nasal fossae [5,6].

Post-operative follow-up (clinical and radiological) showed no residual process, local recurrence or distant metastasis.

Discussion

The palpebral localization of ASC is Extremely Inhabitual and Disorderant with the hypotheses that explain that its histogenesis is of Glandular origin, since this type of histology is frequently found in organs where adenocarcinomas predominate (stomach, uterus) [7-9].

Our case assumes the surface epithelium as histo-genetic origin, and joins the recent publications reporting cases of ASC in the oral, nasal, laryngeal and esophageal mucosa [10].

Histological diagnosis is not easy, as several carcinomas have adenoid features (e.g. mucoepidermal carcinoma) which make it difficult to distinguish ASC, and this highly malignant tumor may be missed [11,12].

Indeed, our case reflects an extreme loco regional aggressiveness, and even if the surgical exeresis was successful (histologically intact surgical margins), the prognosis remains unfavorable and unpredictable.

Conclusion

Adeno-squamous carcinoma is an extremely rare and particularly aggressive histological variety of palpebral tumors, described as high-grade malignancy. It can only be diagnosed by pathological examination.

Awareness of this rare diagnosis allows the surgeon to adapt his or her surgical margins and to carry out armed post-operative surveillance.

References

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Citation: Imad L, Naya K, Hasnaoui I, Abdellah E and Berraho A. Adeno Squamous Palpebral Carcinome with Orbitary Extension: Case Report. Austin J Clin Ophthalmol. 2021; 8(1): 1116.