What is the lesion on this man's eye?

[Soroush Ebrahimi]

From:
http://www.pulsetoday.co.uk/main-conten ... n-on-this-
man-s-eye?sp_rid=NjU3NzMyMTU1MgS2&sp_mid=36990921

What is the lesion on this man's eye?
11 Aug 2011
Dr Mike Wyndham describes how this irregular, growing lesion came to be diagnosed.
The patient
A 62 year old man presented with this red swelling growing out of his eye. It had been enlarging
over a period of a year and his family had urged him to deal with it. Reluctantly, he attended at it
was causing him some irritation.
First instinct
Some sort of benign lesion as it appeared to be soft. I suspected a vascular origin, possibly a
haemangioma, although it did not really appear to be a blood filled lesion
Differential diagnosis
* Papilloma
* Pyogenic granuloma
* Some type of malignancy
The hidden clue
Haemangiomas, papillomas and pyogenic granulomas generally have a limit on their size and this
lesion was continuing to grow. It was also somewhat irregular, while the aforementioned lesions tend
to be smooth. Perhaps the most likely diagnosis was a localised cancer.
Getting on the right track
When you come across an uncommon lesion, you may need help in making the diagnosis and I was very
much in this situation. The ophthalmologist was much more confident when she saw him and felt this
was a conjunctival carcinoma.
The lesion was excised and confirmed as a conjunctival carcinoma. He was requested to instil
interferon alpha eye drops for a period of 3 months after. There has been no recurrence of the
tumour.
Dr Mike Wyndham is a GP in Edgware

Regards
Soroush