Bilateral ocular surface squamous neoplasia in xeroderma pigmentosum patient - A case report

A rare case of a 13yr old male patient presented with photophobia in both eyes and gradually progressive painless mass with watering, itching, and redness in the right eye for 2 months. Best-corrected visual acuity in Right eye 20/200 and Left eye 20/120. On examination, Right eye has a 6 x 6 mm fleshy pink oval pedunculated mass lesion arising from the temporal limbus and a 2mm hyperpigmented lesion in the nasal limbus. Left eye has a gelatinous white flat diffuse lesion with the pigmentation of 3mm both in the nasal and temporal limbus. Both eyes' Anterior segment, ocular motility, and fundus are normal. The patient had multiple hyperpigmented spots (freckles) and scaly skin on the face and trunk suggestive of Xeroderma pigmentosum for which he was on irregular treatment. Right eye tumor mass was excised with intraoperative control of surgical margins with adjunctive cryotherapy and sent for histopathology examination, which was confirmed as squamous neoplasia. Postoperatively, Both eyes started on Topical Mitomycin-c 0.02% 4 cycles, and the patient was carefully followed for any recurrence.