Ophthalmic Artery Embolization as Pretreatment of Orbital Exenteration for Conjunctival Squamous Cell Carcinoma

Introduction: The aim of the study was to report our experience in the use of Gamma Knife Stereotactic Radiosurgery (GKSTRS) for conjunctival squamous cell carcinoma (SCC) invading the orbit, as an alternative to exenteration surgery. Patients and Methods: Patients who had GKSTRS for conjunctival SCC invading the orbit but sparing the bone (AJCC eighth ed. T4a) with a minimum of 1-year follow-up were included. Treatment failure was defined as no decrease in tumour size 3 months post-treatment, or further growth during the follow-up period. Patients were followed up 3-monthly for 2 years and 6-monthly afterwards with a minimum of yearly MR Imaging of orbit. Results: Six patients met the inclusion criteria. MR imaging was used to identify the extent of orbital involvement of SCC. Stereotactic radiosurgery utilizing the Leksell Gamma Knife® Perfexion was delivered in a single session in which patients received 18–20 Gy to the 45–50% isodose. The median follow-up was 29 months. Four patients responded to the treatment and had no evidence of recurrence at their most recent follow-up. The treatment failed in 2 patients, in 1 of whom the tumour was larger and extended deeper into the orbit. The other patient developed a recurrence away from the treated area at 9 months, suggesting a multifocal disease. Both patients had poorly differentiated SCC. Conclusion: GKSTRS is a potential alternative to orbital exenteration surgery for conjunctival SCC extending into the anterior orbit in a selected group of patients refusing orbital exenteration or has a second blind eye. Nevertheless, the disease is more likely to recur than with exenteration surgery, hence lifelong monitoring and low threshold for surgical intervention or retreatment is prudent.

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Proton beam radiotherapy of locally advanced or recurrent conjunctival squamous cell carcinoma: experience of the CATANA Centre

Journal of Radiotherapy in Practice ◽

10.1017/s1460396920000953 ◽

2020 ◽

pp. 1-8

Author(s):

Roberto Milazzotto ◽

Rocco Luca Emanuele Liardo ◽

Giuseppe Privitera ◽

Luigi Raffaele ◽

Vincenzo Salamone ◽

...

Keyword(s):

Overall Survival ◽

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Proton Beam ◽

Squamous Cell ◽

Locally Advanced ◽

Disease Free Survival ◽

Proton Beam Radiotherapy ◽

Conjunctival Squamous Cell Carcinoma ◽

The Impact

Abstract Aim: Conjunctival squamous cell carcinoma (SCC) is a rare tumour of the ocular region and microscopic radical surgical is difficult. There are no single guidelines for therapeutic management and the role of radiation therapy is not clearly defined although conventionally photon or electron beams are used. Proton beam radiotherapy (PBRT) is a new option for a conservative approach and allows good sparing of the organs at risk. Materials and methods: After surgical resection, we collected 15 cases treated at our institution with PBRT. The dose delivered was between 48 and 60 Gy relative biological effectiveness (RBE), with fractions of 12–15 Gy RBE. Results: After an average period of 48 months, the patients achieved excellent disease control (overall survival and disease-free survival: 86·6%), with minimal acute and late toxicity. Findings: In this work, we present our experience on the use of PBRT technique in SCC treatment. A larger sample of patients is needed to draw conclusions about the impact of this treatment on disease recurrence and overall survival.

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The epidemiology of conjunctival squamous cell carcinoma in Uganda

British Journal of Cancer ◽

10.1038/sj.bjc.6600451 ◽

2002 ◽

Vol 87 (3) ◽

pp. 301-308 ◽

Cited By ~ 75

Author(s):

R Newton ◽

◽

J Ziegler ◽

C Ateenyi-Agaba ◽

L Bousarghin ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Conjunctival Squamous Cell Carcinoma

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Differentiation of Pigmented Conjunctival Squamous Cell Carcinoma From Melanoma

Ophthalmic Surgery Lasers and Imaging Retina ◽

10.3928/1542-8877-20030901-14 ◽

2003 ◽

Vol 34 (5) ◽

pp. 406-408

Author(s):

Jerry A Shields ◽

Carol L Shields ◽

Steven Luminais ◽

Ralph C Eagle

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Conjunctival Squamous Cell Carcinoma

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Massive Corneal and Conjunctival Squamous Cell Carcinoma

Ophthalmic Surgery Lasers and Imaging Retina ◽

10.3928/1542-8877-20000101-16 ◽

2000 ◽

Vol 31 (1) ◽

pp. 71-72

Author(s):

Anita Panda ◽

Namrata Sharma ◽

Seema Sen

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Conjunctival Squamous Cell Carcinoma

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Treatment of conjunctival squamous cell carcinoma: balancing disease eradication with minimising treatment-induced morbidity

Malaysian Journal of Ophthalmology ◽

10.35119/myjo.v2i4.122 ◽

2020 ◽

Vol 2 (4) ◽

pp. 288-292

Author(s):

Cameron McLintock ◽

James McKelvie ◽

Samer Hamada

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Surgical Excision ◽

Bulbar Conjunctiva ◽

Palpebral Conjunctiva ◽

Buccal Mucosa Graft ◽

Pigmented Lesion ◽

Conjunctival Squamous Cell Carcinoma ◽

The One

A 41-year-old male presented with a large non-pigmented lesion on the ocular surface involving 8 clock hours of limbus, bulbar conjunctiva, and palpebral conjunctiva. Incisional biopsy confirmed poorly differentiated conjunctival squamous cell carcinoma (SCC). It was staged as a T3, N0, M0 lesion. Treatment was with surgical excision, amniotic membrane transplant, and buccal mucosa graft. Three weekly cycles of 0.04% mitomycin C were administered postoperatively. Six months following excision, although there was no evidence of residual conjunctival SCC, the patient suffered from poor vision, significant pain, and diplopia due to severe dry eye, limbal stem cell deficiency, and symblepharon.This case illustrates the difficult clinical decisions which confront the clinician when treating conjunctival SCC, particularly with balancing the need to eradicate the disease to prevent local invasion and metastatic spread on the one hand and minimising ocular morbidity on the other.

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CONJUNCTIVAL SQUAMOUS CELL CARCINOMA;

The Professional Medical Journal ◽

10.29309/tpmj/2008.15.04.2861 ◽

2008 ◽

Vol 15 (04) ◽

pp. 455-458

Author(s):

MUHAMMAD MUMTAZ CHAUDHRY ◽

SHEHRYAR ALTAF

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

The Elderly ◽

Elderly Men ◽

In Situ Carcinoma ◽

Conjunctival Squamous Cell Carcinoma ◽

Study Setting ◽

Orbital Invasion

Objectives: To evaluate 20 patients with squamous cell carcinoma of the conjunctiva. To determine the clinical andpathological characteristics. Design Retrospective study. Setting: POF hospital & EDO eye hospital Wah.Cantt Period: From June 200 toJuly 2006. Methods: The patients presenting with squamous cell carcinoma of the conjunctiva were retrospectively evaluated. Results: Patientswere usually male (80%), elderly (75% >60 years of age), with most lesions (90%) occurring at the limbus. Two patients (10%) sufferedrecurrence of the squamous cell of the conjunctiva within 2 to 4 months of resection. Corneal invasion was noted in two patients (!0%) whilethere was intraocular and orbital invasion in two patients (10%). One patient (5%) required enucleation and one patient (5%) requiredexenteration. In situ carcinoma was noted in 18 patients (90%). Conclusions: Squamous cell carcinoma of the conjunctiva occurs in the sunexposed area of the conjuntiva at the limbus in the elderly men. Recurrence was noted in the younger patients and with larger lesions.Enucleation and exenteration is required in a small number of cases.

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