Epithelial Conjunctival Tumors
Conjunctival cysts are harmless and benign. Occurrence is most often post-operative (for
example after surgery to correct strabismus), post-traumatic, or spontaneous.
They usually take the form of small clear fluid-filled inclu-sions of
conjunctival epithelium whose goblet cells secrete into the cyst and not on to
the surface (Fig. 4.21). Cysts can lead to a foreign-body sensation and are removed
surgically by marsupialization (removal of the upper half of the cyst).
Papillomas are of viral origin (human
papillomavirus) and may develop from the bulbar or palpebral conjunctiva. They
are benign and do not turn malig-nant.
As in the skin, conjunctival papillomas can occur as branching pediculate tumors or as broad-based lesions on the surface of the conjunctiva (Fig. 4.22). Papillomas produce a permanent foreign-body sensation that is
annoying to the patient, and the entire lesion should be surgically removed.
Conjunctival carcinomas are usually whitish, raised, thickened areas of epithelial tissue whose surface forms a plateau. These lesions are usually ker-atinizing squamous cell carcinomas that develop from epithelial dysplasia (precancer) and progress to a carcinoma in situ (Fig. 4.23). Conjunctival carci-nomas must be excised and a cytologic diagnosis obtained, and the patient must undergo postoperative radiation therapy to prevent growth deep into the orbit.
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