Strawberry-Hued revelations: Unveiling a case of OSSN

CASE HISTORY A 64-year-old woman with multiple comorbidities presented with a complaint of a painless, reddish mass in her right eye that had been increasing in size in the last five years. She denied any past ocular trauma or treatment. Her visual acuity in the affected eye was counting fingers close to face. The slit-lamp examination revealed an approximately 18 × 11 mm papillary mass located nasally, featuring a prominent feeder vessel and hairpin neovascularization, along with encroachment over the cornea from 12 to 7 o’clock [Figure 1], suggestive of the papillary type of ocular surface squamous neoplasia (OSSN). OSSN encompasses a range of conditions, including conjunctival intraepithelial neoplastic lesions (CIN) and invasive squamous cell carcinoma (SCC) of the conjunctiva and cornea. OSSN commonly appears in the interpalpebral region of the perilimbal conjunctiva and can spread across the limbus to affect the cornea.[1]Figure 1: Large 18 × 11 mm papillary mass present nasally, featuring a prominent feeder vessel and hairpin neovascularization, extending from 12 to 7 o’clock area, which is encroaching over the corneaSeveral factors contribute to the development of OSSN, including higher age, male gender, ultraviolet B (UVB) radiation exposure, human papillomavirus (HPV) infection, immunosuppression, and human immunodeficiency virus (HIV) infection. UVB radiation is particularly implicated in the development of various skin and ocular surface cancers due to its role in DNA repair damage.[2] Clinically, OSSN may appear gelatinous, papillary, leukoplakic, or opalescent, with hairpin neovascularization and feeder vessels typically leading to the tumour site. Management options for OSSN include surgical techniques using no-touch technique and topical treatments. Common topical treatments are interferon alpha-2b, 5-fluorouracil, and mitomycin C.[3] Recent advancements in the management of OSSN include the human papillomavirus vaccine, light-activated belzupacap sarotalocan, verteporfin, cidofovir, bevacizumab, retinoic acid, and aloe vera.[4] Unfortunately, due to the patient’s advanced age and multiple comorbidities, she was lost to follow-up for further treatment. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.