Background: Conjunctival intraepithelial neoplasia (CIN) is a precursor lesion of conjunctival squamous cell carcinoma (SCC). CIN recurs frequently but progresses less aggressively than SCC. We report 2 cases of recurrent CIN in immunosuppressed patients.
Case 1: A 60-year-old woman had been taking oral immunosuppressive drugs for 30 years for systemic lupus erythematosus. In 2005, both conjunctival tumor and high serum SCC levels were noted. Biopsy revealed right eye CIN and left eye SCC, and extended resection was performed. In 2008, right eye CIN recurred accompanied by high serum SCC levels and another extended resection was performed. The patient was free from recurrence for 1 year until her death.
Case 2: A 43-year-old woman who had been taking oral immunosuppressive drugs for 3 years for nephrotic syndrome. She had twice undergone right corneal transplantation for keratoconus. In 2011, right conjunctival tumor and high serum SCC levels were noted. Biopsy revealed right eye CIN, for which an extended resection was performed. At present she remains free from recurrence.
Conclusion: CIN can recur in immunosuppressed patients. We suggest that serum SCC levels be monitored to help detect recurrence.