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Presentation type	E-poster
Title	Behind the red eye: a case of recurrent cutaneous Squamous Cell Carcinoma (SCC) disguised as conjunctivitis

Purpose	A 84-year-old man presented for a routine cataract surgery of the right eye. An incidental atypical red eye with mild chemosis of the left eye was found.He has a history of cutaneous squamous cell carcinoma (SCC) of 2.2x 1 cm, grade pT3NxMx, with perineural invasion It was declared healed after excision with tight deep free margins of < 0.5cm and additional radiotherapy in 2022,.
Methods	The patient underwent eventless cataract surgery in the right eye, after which a red left eye with mild chemosis and exposure keratopathy on the day of surgery was observed incidentally. Initial treatment was administered without improvement. Further diagnostic workup, including a CT scan, followed by MRI of the orbitae and brain was performed
Results	The radiologic imaging revealed an orbital infiltrative lesion on the left side. Given the general condition of the patient and the risk of infection, no biopsy was performed. A radiological diagnosis of recurrent SCC with staging pT4NxMx, was made. Since this is non-operable, the patient was treated with 4 cycles of cemiplimab, which is an immune checkpoint inhibitor. Tumor control was achieved, with no progression on imagery after 6 months of treatment with cemiplimab
Conclusion	This case highlights the importance of considering recurrent malignancy in patients with a history of cancer presenting with atypical ocular symptoms. Early and accurate diagnosis is crucial for appropriate management and treatment
Conflict of interest	No

Authors 1