Intra-epithelial epithelioma of the conjunctiva and the cornea (Bowen's disease) healed by contact radiotherapy.

Abstract

Clinic, University ofGhent,Belgium. APARTfromtheclassical epitheliomata ofthebulbar conjunctiva, whether epidermoid ornot,attention should bedrawntotheintraepithelial epitheliomata, observed byBowensince 1912onthelevel oftheskinandalsosinceobserved onthelevel ofthemucous membranes. McGavic(1942) reported five observations ofthis typeofmalignanttumouronthelevel oftheconjunctiva andthecornea. Other caseshavebeendescribed byWise(1943), Khanolkar (1946), and Esterman, Laval, andOkrainetz (1947). Thistumourischaracterized by a proliferation ofepithelial cells within theepithelium itself, there beingnoperforation ofthe basal membrane, atleast until alongtimehaselapsed, noinvasion oftheneighbouring tissuies, andnoformation ofmetastases. Thetreatment ofepibulbar epitheliomata, nomatter whatthe anatomo-pathological typemaybe,isreputed tobeverydisappointing. X rays(Heckel, 1922) andradium(Mattice, 1914; Collins, 1915;RadosandSchinz, 1922) havemetwithnotorious failure. Local excision aswellaselectrocoagulation isveryoften followed byarelapse. Thisiswhymostauthors, including DukeElder(1946) and\e'rigot deTreignv (1939), donothesitate to resort todrastic measures andadvise enucleation oftheeve-ball orevenexenteration oftheorbit, ifthelesions areveryexten sive. We hadtheopportunity toobserve anintra-epithelial epithelioma oftheconjutctiva andthecorneawhichwe wereabletoheal completely andwithout sequelae bycontact radiotherapy. This success beyondexpectation encouraged ustopublish ourobservation,as,theeffectlveness ofthistreatment beingconfirmed, the prognosis ofepibulbar epitheliomata will bewhollv modified.