Conjunctival involvement with corneal extension in pediatric mycosis fungoides. Surgical and immunomodulatory management.

A 13-year-old boy with mycosis fungoides (MF) presented with uncommon ophthalmic involvement. Clinical examination revealed a vascularized conjunctival nodule with corneal extension involving the visual axis and causing severe visual impairment. Initial treatment with topical corticosteroids and tacrolimus showed poor response. Complete surgical excision was performed for diagnostic and therapeutic purposes. Histopathological analysis confirmed progression to T-cell lymphoma. Adjuvant treatment with topical interferon alfa-2b was initiated. After two years of follow-up, no recurrence was observed, with partial visual improvement. This case highlights a rare pediatric presentation and central corneal involvement, both infrequently described. Combined surgical and immunomodulatory treatment achieved adequate local control, although residual sequelae limiting visual acuity persisted.