[Is less more in individual cases? Minimal treatment for squamous cell carcinoma of the conjunctiva with orbital invasion].

A 75-year-old female patient presented with a sensation of pressure and a prominence on the right lower eyelid. The computed tomography (CT) of the orbit showed a space-occupying lesion and an anterior transconjunctival orbitotomy with excisional biopsy and cryotherapy of the margins was carried out. The pathological results showed a poorly differentiated nonkeratinizing squamous cell carcinoma (R1). The whole-body staging indicated a primary squamous cell carcinoma of the conjunctiva with orbital invasion of the right eye. The patient refused an orbital exenteration and also adjuvant radiotherapy. Therefore, after a second resection and cryotherapy the patient was treated with a total of 4 cycles of mitomycin C eyedrops due to the residual conjunctival intraepithelial neoplasia (CIN) fragments in the marginal region. This treatment was carried out bilaterally as the contralateral eye showed a CIN grade II. The patient is currently recurrence-free for more than 2 years but the left eye still shows a CIN grade II. In cases of an orbital invasion of a primary squamous cell carcinoma of the conjunctiva treatment with tumor excision, cryotherapy and local chemotherapy can also represent a treatment option.