[Leukoplakia of the lower tarsal conjunctiva].

The case of a 73-year-old woman with a perforated corneal ulcer in the remaining eye with migrating endophthalmitis is presented. In addition, the affected eye had non-abradable whitish coating (leukoplakia) on the tarsal conjunctiva. The cause of leukoplakia was initially histologically diagnosed after an incisional biopsy as focal invasive sebaceous carcinoma with pagetoid growth. After exenteration of the orbit it was confirmed to be an early invasive, non-keratinizing squamous cell carcinoma (G2) of the conjunctiva, which had emerged from a spinocellular carcinoma in situ. The early histological differentiation of malignant lesions in the conjunctiva can be extremely difficult because the pathological changes in the tissue are very similar due to the cell metaplasia.