Squamous cell carcinoma

22 year old female who was recently diagnosed with HIV. She was started on antiretroviral therapy (ARVs) about three months ago. She states that this lesion appeared and grew over the last four weeks (unsure if this is reliable history or not). The visual acuity in this right eye was hand motions, due to the large squamous cell carcinoma that was involving the visual axis.

Squamous cell carcinoma in patient with HIV. Current CD4 count was 217 cells/mm³.

 

Subconjunctival injection of lidocaine prior to excision. It did not appear to invade the sclera, so we proceeded with primary excision. If the sclera had been involved, we would have enucleated the eye.

Status post excision. We did have to take down the medial rectus and reinsert it. We used Mitomycin C (antimetabolite) to help prevent recurrence. The patient was counselled that should the cancer recur, she will need to have the eye enucleated.