HPV16 conjunctival squamous cell carcinoma

A 38-years-old Nigerian man presented with an enlarged and vascularized conjunctival lesion covering the corneal surface of the left eye, associated with an upper bulbar conjunctival nodule (Fig. 1a). Magnetic resonance imaging (MRI) showed a thickened and contrast-enhancing corneal and conjunctival-scleral lesion, mostly evident in the upper lateral surface, close to the superior and lateral rectus muscles and lacrimal gland, which appeared enlarged (Fig. 1b and 1c). No bone erosion of orbital walls was demonstrated on computed tomography (CT) (Fig. 1d). After surgical evaluation, the patient underwent orbital exenteration and reconstruction using temporalis muscle. At histopathologic examination, the diagnosis was moderately-differentiated squamous cell carcinoma (Fig. 1e and 1f), extended to the conjunctive with infiltration of periocular striated muscles. Immunohistochemical examination revealed the positivity for p16 (Fig. 1g) demonstrating a correlation with HPV, later confirmed by HPV-DNA PCR analysis. Today, 5 years after surgery the patient is in well-health with no signs of recurrence.