|Year : 1978 | Volume
| Issue : 2 | Page : 35-36
Metatypical carcinoma of eye lid (A case report)
SC Gupta1, MS Vyas1, OP Acharya1, IN Ramdeo2
1 Department of Ophthalmology, J.L.N. Medical College, Ajmere, India
2 Department of Pathology, S.P. Medical College, Bikaner, (Rajasthan), India
S C Gupta
Department of Ophthalmology, J.L.N. Medical College, Ajmere
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Gupta S C, Vyas M S, Acharya O P, Ramdeo I N. Metatypical carcinoma of eye lid (A case report). Indian J Ophthalmol 1978;26:35-6
Metatypical carcinoma is the least common variety of the carcinoma lid. The commonest carcinoma at this site being basal cell carcinoma followed by squamous cell carcinoma. Metatypical (Baso-squamous) carcinoma lie between these two extremes and has also been called as intermediate carcinoma. The rarity of the lesion merits its documentation.
| Case Report|| |
A 50 years old Hindu Female (L.K.) was admitted in the eye ward of S.P. Medical College. Hospital, Bikaner with the complaint of painless growth on the left upper eye lid for the last three years. It started as a painless gradually increasing nodule, more in the last one month. On examination the left eve-ball was found to be phthisical with marked oedema of lid. There was a triangular ulcer (approx. 4x3 cm) with irregular raised borders extending from the lateral half of the orbital wall up to mid temple. The underlying bone was exposed. It was foul smelling with purulent discharge. The medial half of the upper eye lid was hypertrophied and a firm growth (3 cm x 2 cm) was present extending up to inferior orbital border, which was bleeding on touch. No regional lymph nodes were palpable. Right eye was having immature cataract with 3/60 vision.
General and systemic examination revealed patient to be markedly weak and cachectic. No other abnormality was detected on systemic examination. Ear, nose, and throat examination did not reveal any significant abnormality, skiagram of skull and paranasal sinuses were normal.
Patient was kept on systemic broad spectrum antibiotics, initially for systemic infections. It subsided within a period of seven days. Two pieces of tissues were incised from lateral and medical sides of the growth and subjected to histopathological examination.
Histological examination of the biopsy revealed growth pattern of basal cell carcinoma but individual tumor cells showed features of squamous cells with slight eosinophilic cytoplasm and absence of intracellular bridges. A diagnosis of metatypical carcinoma was made.
The patient was given radio-therapy with a total dose of 6000 r in 30 sittings associated with general build up therapy comprising of proteins, vitamins and hematinics. Local dressing with broad spectrum ointment and normal saline was continued. There was remarkable improvement in the condition of the patient.. The growth present on the medial side of the lid disappeared completely and gradually skin grew over the bare area of temporal and zygomatic bones. At the time of discharge only a small notch of approx. 5 mm size was present on the lateral side of the left upper lid.
| Discussion|| |
The old concept that the basal cell carcinoma arises from basal cells and squamous cell-carcinoma from prickle cells has lately been abandoned. It is now generally believed that cutaneous epithelial cells are pleuri-potential throughout life ., The prevailing view is that there is no histogenetic difference between the two.
The difference between them is that basal-cell carcinoma develops toward higher and squamous-cell carcinoma toward lower organ differentiation. Basal-cell carcinomas tend to be sustained locally, while squamous-cell carcinomas are beyond local regulatory forces, and metastasize.
Tumours in which either the cell type and/ or the arrangements of the cells causes difficulty in deciding between basal cell carcinoma or squamous cell carcinoma ; they have occasionally been classified as baso-squamous cell carcinoma. In these tumours the growth pattern is like that of a basal cell carcinoma but the individual cells have a more squamous appearance and may show parakeratosis and are best classified as metatypical. There may be a transitional stage between the two or one part of the tumour may be basal cell and other squamous. These tumours are slow growing and have the course of the basal cell variety, but their potentialities to harm are greater than those of the pure basal-cell type.
| Summary|| |
A rare case of metatypical carcinoma, responding well to the radiotherapy and general supportive therapy has been documented.
| Acknowledgement|| |
Our thanks are due to Dr. K.D. Gupta, Principal, S.P. Medical College, Bikaner for allowing us to use the hospital records for publication.
| References|| |
Duke-Elder-(1952) Text Book of Ophthalmology, 5,
Kligman, A.M. Pinkus, H. (1960) Arch. Dermat.& Syph,
Montagna, 1956. The Structure and function of the skin, New York academic Press.
Reese, 1963, Tumours of the Eye, 1.
W.H.O. 1974. Histological typing of Skin tumours, 12, 50.
[Figure - 1], [Figure - 2]