From Seed to Spread: Lacrimal Sac Squamous Cell Carcinoma Blossoming Into Orbital Chaos.

Non-cutaneous squamous cell carcinoma (ncSCC) is a rare malignancy, especially involving the orbital and lacrimal apparatus. Hereby, we present a case of recurrence of squamous cell carcinoma (SCC) in the left orbit after excision of lacrimal sac SCC and radiotherapy. She presented with acute painful visual impairment with a frontal headache, with imaging showing medial extraconal and intraconal mass. After confirmation of SCC from the biopsy, modified enucleation was done. However, the patient had a recurrence of SCC, and further debulking was performed with palliative measures. Noteworthy, ncSCC is a rare malignancy with an aggressive nature. Orbital SCC has the worst prognosis compared to conjunctiva or lacrimal sac SCC. Surgery remained the mainstay for higher survival, but chemotherapy and radiotherapy were not associated with a better prognosis, yet there is a lack of data regarding recurrence and its management. In conclusion, ncSCC is a rare and challenging disease that requires timely intervention with multiple disciplinary care, especially when it is spread from the lacrimal sac to the orbital.

Bilateral Eyelid Polyposis Due to Eccrine Hidrocystoma.

This case report discusses a diagnosis of eccrine hidrocystoma in a female patient aged 65 years who presented with bilateral, painless eyelid masses.

Choroidal Melanoma: A Case Series From Malaysia.

INTRODUCTION: Choroidal melanoma is one of the subtypes of uveal melanoma and a relatively rare ophthalmic malignancy worldwide. However, it is scarce in Asian countries like Malaysia. PURPOSE: We present eight cases of patients with choroidal melanoma referred to Hospital Serdang, a tertiary centre for oculoplastic issues, from 2021 to 2022. METHOD:  A retrospective case series of patients diagnosed with choroidal melanoma and referred to the Oculoplastic Clinic, Department of Ophthalmology, Hospital Serdang, was undertaken. RESULTS: A total of eight cases of choroidal melanoma were identified, with a median age of 65 years. Six of them were female, and two were male. There were five of Malay ethnicity, and three were Chinese. Progressive reduced vision (n = 6), noticeable ocular mass (n = 3), and visual field defect (n = 2) were the most common presenting symptoms. The mean tumour thickness was 21.25 mm (range = 10-56 mm), and the largest basal diameter ranged from 10 mm to 53 mm (mean = 22.5 mm). Most were large tumours (n = 7) and above the T3a stage. The level of lactate dehydrogenase (LDH) was elevated in three cases. Histopathologically, five of the tumours were epithelioid, while the other three were mixed types. All patients underwent enucleation (n = 5) and exenteration (n = 3) with one recurrence. One patient had liver metastasis on the diagnosis of choroidal melanoma. CONCLUSION: In Malaysia, there is an increasing number of cases of choroidal melanoma. Clinical evaluation remained the mainstay of diagnosis. Treatment should be based on multifactorial prognostication in addition to tumour size. The LDH level may be necessary for providing inexpensive but valuable prognostication and monitoring markers.