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Anterior segment optical coherence tomography (AS-OCT) revealed a compact-appearing, mildly reflective subepithelial lesion with back shadowing. Clinical differentials of benign reactive lymphoid hyperplasia and conjunctival lymphoma were considered and an excisional biopsy was performed. Histopathology revealed a cellular stromal tumour comprising spindle cells arranged in short fascicles. The Ki-67 index was 6%. Immunohistochemistry with signal transducer and activator of transcription 6 (STAT-6) showed moderate nuclear expression in lesional cells and giant cells. Correlating the histomorphology and STAT-6 positivity, a final diagnosis of conjunctival solitary fibrous tumour was made. Subsequent Ru-106 plaque radiotherapy was administered at a dose of 50 Gy to the site of the lesion. The patient was doing well with no signs of tumour recurrence at the 18-month follow-up. The novelty of this report lies in the illustration of AS-OCT findings, CD34-negative phenotype and the use of adjuvant Ru-106 plaque brachytherapy.<\/jats:p>","DOI":"10.1136\/bcr-2025-267268","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T12:10:11Z","timestamp":1785845411000},"page":"e267268","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Solitary fibrous tumour of the conjunctiva: a rare presentation"],"prefix":"10.1136","volume":"19","author":[{"given":"Sruthi R","family":"Sreekumar","sequence":"first","affiliation":[{"name":"Ocular Oncology Service, Operation Eyesight Universal Institute for Eye Cancer, LV Prasad Eye Institute, Hyderabad, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijitha S","family":"Vempuluru","sequence":"additional","affiliation":[{"name":"Ocular Oncology Service, Operation Eyesight Universal Institute for Eye Cancer, LV Prasad Eye Institute, Hyderabad, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saumya","family":"Jakati","sequence":"additional","affiliation":[{"name":"Ophthalmic Pathology Department, LV Prasad Eye Institute, Hyderabad, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0800-9961","authenticated-orcid":false,"given":"Swathi","family":"Kaliki","sequence":"additional","affiliation":[{"name":"Ocular Oncology Service, Operation Eyesight Universal Institute for Eye Cancer, LV Prasad Eye Institute, Hyderabad, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"key":"2026080405100486000_19.8.e267268.1","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1038\/s41433-022-02160-w","article-title":"A review of solitary fibrous tumours of the orbit and ocular adnexa","volume":"37","author":"Ren\u00e9","year":"2023","journal-title":"Eye (Lond)"},{"key":"2026080405100486000_19.8.e267268.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2010.05.021"},{"key":"2026080405100486000_19.8.e267268.3","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1097\/00004397-198202210-00011","article-title":"Hemangiopericytoma","volume":"22","author":"Searl","year":"1982","journal-title":"Int Ophthalmol Clin"},{"key":"2026080405100486000_19.8.e267268.4","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/S0161-6420(86)33755-2","article-title":"Hemangiopericytoma of the conjunctiva. 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