Recurrent Cutaneous Squamous Cell Carcinoma Presenting as an atypical red eye
Author: Nima Sadeghi
Base Hospital / Institution: UZ Brussel
ePoster presentation
Abstract ID: 25-358
Purpose
Cutaneous SCC with orbital invasion represents a rare but clinically significant complication, particularly in cases with prior perineural involvement. While complete surgical excision remains the gold standard for localized disease, management becomes challenging when recurrence involves critical structures or occurs in medically complex patients. Recent advances in immunotherapy, particularly PD-1 inhibitors like cemiplimab, have expanded treatment options for unresectable cases.
Methods
An 84-year-old Caucasian male was referred for cataract extraction due to bilateral cataracts causing vision loss. His medical history included mild dementia, chronic renal disease, and ulcerative periocular cutaneous squamous cell carcinoma of the left side of the face, grade pT3NxMx with perineural invasion, which was treated with excision and radiotherapy (45 Gy) in 2022. On examination, a red left eye with mild chemosis was noted. Despite treatment, there was no improvement, prompting further investigation. Imaging revealed an orbital infiltrative lesion on the left side, grade T4NxMx with orbital infiltration, without distant metastasis. Biopsy was not done due to infection risk and the patient’s inability for narcosis.
Results
The patient was referred to oncology and treated with Cemiplimab. Following treatment, imaging showed no tumor progression after six months of follow-up. The patient tolerated cemiplimab well without significant adverse effects.
Conclusion
This case illustrates the importance of considering recurrent malignancy in patients with a history of cancer who present with atypical ocular symptoms, even years after treatment. Early and accurate diagnosis significantly influences patient outcomes. Cemiplimab, presents a promising alternative for non-resectable tumors, offering a path to disease control without the functional and aesthetic consequences associated with extensive surgical removal. This case contributes to the growing evidence supporting cemiplimab’s efficacy in treating locally advanced SCC, reinforcing its role in patients unsuitable for surgery.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Jozef | Depla | AZ Monica, Deurne |
