Histopathology-guided management of ocular surface squamous neoplasia with corneal stromal or scleral invasion using ruthenium-106 plaque brachytherapy

2021 ◽  
pp. bjophthalmol-2021-319201
Author(s):  
Raksha Rao ◽  
Santosh G Honavar ◽  
Sumeet Lahane ◽  
Kaustubh Mulay ◽  
Vijayanand Palkonda Reddy
Keyword(s):  
Visual Acuity ◽  
Ocular Surface ◽  
Case Series ◽  
Prior Treatment ◽  
Tumour Regression ◽  
Excision Biopsy ◽  
Invasive Squamous Cell Carcinoma ◽  
Ocular Surface Squamous Neoplasia ◽  
Basal Diameter ◽  
Plaque Brachytherapy

Background/aimTo evaluate the safety and efficacy of ruthenium-106 (Ru-106) plaque brachytherapy in managing invasive ocular surface squamous neoplasia (OSSN).MethodsThis is a retrospective, non-comparative, interventional case series of 42 eyes with OSSN with histopathologically-proven corneal stromal and/or scleral invasion that underwent Ru-106 plaque brachytherapy. Main outcome measures were tumour regression, eye salvage, final visual acuity, treatment complications and metastasis.ResultsAt presentation, the mean tumour basal diameter was 9.3 mm (range 5–26 mm) and thickness 3.1 mm (range 1.5–11 mm). Prior treatment included excision biopsy in two patients (5%), incision biopsy and topical interferon in one each (2%). Following excision with 4 mm clinically clear margins, corneal stromal and/or scleral invasion of OSSN was confirmed in all 42 cases, with the excised base showing invasive squamous cell carcinoma. A total dose of 5000 cGy over a mean duration of 19.7 hours (range 7–41 hours) was provided to an axial depth of 2 mm using Ru-106 surface plaque. Over a mean follow-up of 36.9 months (range 22.3–72 months), complete tumour regression was achieved in all eyes (100%). Two eyes (5%) showed conjunctival tumour growth remote from the site of prior treatment. Visual acuity was maintained at ≥20/200 in 35 eyes (83%), with a loss of >2 Snellen lines in 1 eye (2%). There was no evidence of regional lymph node or systemic metastasis.ConclusionHistopathology-guided use of Ru-106 surface plaque brachytherapy is a safe and an effective adjuvant therapy in the management of corneal stromal and/or scleral invasion of OSSN.

Bilateral ocular surface squamous neoplasia: A study of 25 patients and review of literature

2021 ◽  
pp. 112067212110071
Author(s):  
Vijitha S Vempuluru ◽  
Monalisha Pattnaik ◽  
Neha Ghose ◽  
Swathi Kaliki
Keyword(s):  
Risk Factors ◽  
Ocular Surface ◽  
Histopathological Examination ◽  
Topical Steroid ◽  
Case Series ◽  
Intraepithelial Neoplasia ◽  
Excisional Biopsy ◽  
Ocular Surface Squamous Neoplasia ◽  
Retrospective Case

Purpose: To describe the risk factors, clinical presentation, management, and outcomes of patients with bilateral ocular surface squamous neoplasia (OSSN). Methods: Retrospective case series. Results: Of the 25 patients with bilateral OSSN, the mean age at diagnosis of OSSN was 31 years (median, 24 years; range, 2–60 years). Risk factors for bilateral OSSN included xeroderma pigmentosum ( n = 15, 60%), human immunodeficiency virus infection ( n = 3, 12%), conjunctival xerosis ( n = 1, 4%), and topical steroid use ( n = 1, 4%). There were no identifiable ocular or systemic risk factors in 7 (28%) patients. Presentation was synchronous in 14 (56%) and metachronous in 11 (44%) patients. Tumor morphology was bilaterally similar in 12 (48%) patients. Histopathological examination ( n = 36) revealed conjunctival intraepithelial neoplasia (CIN) grade 1 in 4 (8%); grade 2 in 7 (14%); carcinoma in situ in 5 (10%), and invasive carcinoma in 20 (40%). Primary management of OSSN ( n = 49) included excisional biopsy ( n = 31, 62%), topical immunotherapy (IFN α2B) ( n = 11; 22%), topical Mitomycin C (MMC) ( n = 3, 6%), enucleation ( n = 1, 2%), orbital exenteration ( n = 2, 4%), and plaque brachytherapy (PBT) ( n = 1, 2%). One patient was lost to follow-up after detection of tumor in the second eye. Recurrent tumors were noted in 16 (32%) eyes and binocular globe salvage was achieved in 16 (64%) patients at a mean follow up of 41 months (median 30 months; range, 1–164 months). Conclusion: OSSN occurrence can be synchronous or metachronous. Meticulous examination of the fellow eye is important for an early diagnosis of OSSN.

scholarly journals Clinico-Pathological Study of Ocular Surface Squamous Neoplasia in a Tertiary Care Centre of Western Region of Nepal

2019 ◽  
Vol 7 (1) ◽  
pp. 9-13
Author(s):  
Sushila Patel ◽  
Binita Bhattarai Pokharel ◽  
Anita Shah ◽  
Manita Sunam Goda ◽  
Saraswati Khadka Thapa
Keyword(s):  
Ocular Surface ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Western Region ◽  
Invasive Squamous Cell Carcinoma ◽  
Care Centre ◽  
Ocular Surface Squamous Neoplasia ◽  
Tertiary Care Centre ◽  
Male Predominance ◽  
Wide Range

INTRODUCTION: Ocular surface squamous neoplasia (OSSN) consists of a wide range of conjunctival and corneal lesions ranging from dysplastic lesions to invasive squamous cell carcinoma. In recent times, the incidence of OSSN seems to be on the rise, especially in developing countries. The present study was aimed to analyse demographic pattern, clinical characteristics, and histopathology findings of OSSN in a tertiary care centre of western region of Nepal.  MATERIAL AND METHODS: It was a retrospective study. We analyzed 94 cases of OSSN who presented to cornea department of Lumbini Eye Institute, Bhairahawa, Nepal over a period 1.5 years from 1st July 2017 to 31st December 2018. All the patients with OSSN, detailed clinical history and examination were recorded. Lesions were excised with a 3 mm margin clearance and sent for histopathological examination.  RESULTS: Mean age of our patients with OSSN was 48.89±17.955 years ranging from 17 to 85 years. There were 52 (55.32%) male and 42 (44.68%) female. Mean duration of presentation was 6.34±6.17 months. A solitary nodule at the limbus was the commonest presentation. Right eyes were involved more than left eyes. Lesions were found most commonly on temporal site 52 (55.32%) followed by nasal 36 (38.30%). On histopathological examination benign lesions were found in 31 (32.98%) eyes, preinvasive lesion in 50 (53.19%) eyes and invasive lesions in 13 (13.83%) eyes.  CONCLUSION: OSSN were seen more commonly in young adults with male predominance. Benign and pre invasive lesions are found more commonly than invasive lesions.

Ocular surface biopsies of patients with xeroderma pigmentosum in the United Kingdom: a retrospective observational case series

2020 ◽  
pp. bjophthalmol-2020-316125
Author(s):  
John Vekinis ◽  
Ana M Susana Morley
Keyword(s):  
Ocular Surface ◽  
Xeroderma Pigmentosum ◽  
Case Series ◽  
Additional Treatment ◽  
Histopathological Analysis ◽  
Ocular Surface Squamous Neoplasia ◽  
Clinically Normal ◽  
The United Kingdom ◽  
The Uk ◽  
Inflammatory Changes

Background/AimsTo describe the results of all ocular surface biopsies performed on patients with xeroderma pigmentosum (XP) under the care of the UK Nationally Commissioned XP Service as well as the treatment of any subsequent ocular surface conditions diagnosed.MethodsRetrospective analysis of medical records. All patients with XP seen by the service from 2010 to 2019 were included and those with ocular surface biopsies were identified. Data was collected on demographics, complementation subgroup (A–G and V), biopsy details, histopathological analysis and subsequent management.ResultsOf 108 patients seen in our service, 17 underwent at least one ocular surface biopsy. 45 biopsy samples were available from 13 patients of which 65% were performed on patients from complementation subgroup C (XP-C). Biopsies were categorised as either non-mapping (clinically abnormal ocular surface tissue) or mapping (multiple sites including clinically normal tissue). 67 percent of non-mapping biopsies had a mass as their indication and 46% showed ocular surface squamous neoplasia. General non-dysplastic damage was seen in 67% of non-mapping biopsies and melanocytic changes were seen in 25% of non-mapping and 81% of mapping biopsies. 47 percent of biopsy outcomes required no additional treatment but, of those that did, 50% received mitomycin C.ConclusionsThis is the largest reported series of ocular surface biopsies in patients with XP. It identifies a background of ocular surface melanocytic, degenerative and inflammatory changes, with patients with XP-C showing the most severe effects. We highlight challenges faced in interpreting their histopathology and in planning subsequent treatments.

scholarly journals Limbal Pseudoepitheliomatous Hyperplasia Mimicking Ocular Surface Squamous Neoplasia in Palpebral Vernal Keratoconjunctivitis

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Chintan Malhotra ◽  
Arun K. Jain ◽  
Bikram Thapa
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Malignant Transformation ◽  
Ocular Surface ◽  
Dense Plasma ◽  
Vernal Keratoconjunctivitis ◽  
Excision Biopsy ◽  
Ocular Surface Squamous Neoplasia ◽  
Pseudoepitheliomatous Hyperplasia ◽  
Uncommon Presentation

Purpose. Pseudoepitheliomatous hyperplasia at the limbus can mimic an ocular surface squamous neoplasia. It is an uncommon manifestation of vernal keratoconjunctivitis and has been reported previously in limbal VKC. It, however, has not been reported as a manifestation in the palpebral form of the disease and needs to be kept in the differential diagnosis of a limbal mass lesion in vernal keratoconjunctivitis.Case Report. We report the case of a 24 year old male patient having palpebral VKC and presenting with a papillomatous limbal mass with focal areas of keratinization mimicking an ocular surface squamous neoplasia. An excision biopsy was performed, and the specimen sent for histopathologywhich revealed features of pseudoepitheliomatous hyperplasia with no evidence of dysplasia or malignant transformation. The subepithelium revealed a dense plasma-rich inflammation.Discussion. We report this relatively uncommon presentation of limbal pseudoepitheliomatous hyperplasia mimicking an ocular surface squamous neoplasia in palpebral vernal keratoconjunctivitis. Wide excision as is required for an ocular surface neoplasia may thus be avoided if this entity is recognized in vernal keratoconjunctivitis.

scholarly journals Palladium-103 plaque therapy for multifocal iris melanoma: Radiation of the entire anterior segment of the eye

2020 ◽  
pp. 112067212091423
Author(s):  
Paul T Finger ◽  
Ankit Singh Tomar ◽  
Kimberly J Chin
Keyword(s):  
Visual Acuity ◽  
Local Control ◽  
Anterior Segment ◽  
Case Series ◽  
Corneal Opacity ◽  
Iris Melanoma ◽  
Good Visual Acuity ◽  
Eye Plaque ◽  
Plaque Brachytherapy

Purpose: To investigate the safety and tolerability of total anterior segment palladium-103 (103Pd) eye plaque brachytherapy for multifocal iris melanoma. Methods: Interventional case series of 11 patients with multifocal iris melanomas. Anterior segment ultrasound revealed tumor size, location, and intraocular margins. Epicorneal amniotic membrane grafts protected the cornea and decreased pain during total anterior segment 103-Pd ophthalmic plaque brachytherapy. Results: Eleven diffuse iris melanomas were American Joint Committee on Cancer 8th edition–classified as T1 (n = 5, 45.5%) and T2 (n = 6, 54.5%). Plaque radiation was completed to a minimum mean tumor dose of 85 Gy (mean dose rate, 58.1 cGy/h). Ultrasonographic tumor thickness regression was 41% (follow up mean 58.7, median 50, range: 8–139 months). Despite 100% local control and 100% eye retention, one patient (9.1%) developed metastatic disease. Four eyes required cataract surgery. There was no corneal stem-cell deficiency, corneal opacity, radiation maculopathy, or optic neuropathy. While visual acuity prior to treatment was 20/40 or better in 10 (91%), 9 were 20/40 or better (81.9%) at last follow-up. Four (36%) had glaucoma prior to treatment and three eyes developed glaucoma after treatment for a total of 63%. Conclusion: Total anterior segment (103Pd) plaque brachytherapy resulted in local control, good visual acuity, eye and life preservation in the treatment of multifocal iris melanoma.

Karakteristik pasien ocular surface squamous neoplasia di Pusat Mata Nasional RS Mata Cicendo periode Januari 2012- Juni 2014

2019 ◽  
Vol 43 (1) ◽  
pp. 40
Author(s):  
Sandraningrum Sandraningrum ◽  
M Rinaldy Dahlan
Keyword(s):  
Ocular Surface ◽  
Wide Excision ◽  
Invasive Squamous Cell Carcinoma ◽  
Ocular Surface Squamous Neoplasia ◽  
Surface Mass ◽  
Broad Term ◽  
The Mean ◽  
Excisional Surgery ◽  
Histopathology Examination

Background: Ocular surface squamous neoplasia (OSSN) is a broad term encompassing conjunctival intraepithelial neoplastic lesions (CIN) and invasive squamous cell carcinoma (SCC) of conjunctiva and cornea. The purpose of this study is to describe the demographic, clinical, therapy and histopathology characteristics of OSSNs patients in Cicendo Eye Center within period of January 2012 – June 2014. Methods: Patient medical records were reviewed. Fourty patients of biopsy-proven OSSN at Cicendo Eye Centre from January 2012 until June 2014 were reviewed. Results: Data was collected from 40 patients (41 eyes), OSSN was more frequent in men (62.5%) and had unilateral presentation (97.5%). The mean patient age was 45.9±14.7 years. The most common complaint was lump on the ocular surface (50%). The size of lesion was mostly less than 2 mm (62.5%). All of the patients were managed with surgery using wide excision and histopathology examination, of whom 46.4% cases were managed with wide excision only, 41.4% cases were managed with wide excision and application of topical mitomycin C (MMC), 12.2% cases were managed with wide excision, application of topical MMC, and cryotherapy. Histopathology examination revealed that 41.5% cases were CIN, 19.5% cases were carcinoma in situ, and 39% cases were invasive SCC. Conclusions: Patients with OSSN who came to Cicendo Eye Center were mostly male and had unilateral presentation. The most common clinical sign and symptom were ocular surface mass with size of the lesion less than 2 mm. Management of patient with OSSN is mostly excisional surgery only. Majority of histopathology examination showed CIN.

scholarly journals An Unusual Case of Wart-like Presentation of Ocular Surface Squamous Neoplasia

2019 ◽  
Vol 2 (2) ◽  
pp. 270-271
Author(s):  
Nirsara Shrestha ◽  
Sangeeta Shrestha ◽  
Arjun Shrestha
Keyword(s):  
Ocular Surface ◽  
Carcinoma In Situ ◽  
Unusual Case ◽  
Intraepithelial Neoplasia ◽  
Excisional Biopsy ◽  
Invasive Squamous Cell Carcinoma ◽  
Severe Dysplasia ◽  
High Grade ◽  
Ocular Surface Squamous Neoplasia

The ocular surface squamous neoplasia refers to the entire spectrum ranging from mild to severe dysplasia to carcinoma in situ and invasive squamous cell carcinoma. Ocular surface squamous neoplasia may present clinically in various ways: gelatinous, velvety or papilliform or leukoplakic. This case report describes a 50-year-old male who presented with a filiform wart-like appearance of conjunctival mass unlike described earlier. Excisional biopsy was done and histopathology revealed intraepithelial neoplasia with high-grade dysplasia.

scholarly journals Szemfelszíni laphám-neoplasia

2017 ◽  
Vol 158 (51) ◽  
pp. 2011-2022 ◽  
Author(s):  
Gábor Tóth ◽  
Gábor László Sándor ◽  
Andrea Gyenes ◽  
Jeannette Tóth ◽  
Berthold Seitz ◽  
...  
Keyword(s):  
Ocular Surface ◽  
Treatment Options ◽  
Intraepithelial Neoplasia ◽  
Invasive Squamous Cell Carcinoma ◽  
Ocular Surface Squamous Neoplasia ◽  
Adequate Treatment ◽  
Regular Control ◽  
Low Malignant Potential ◽  
Life Threatening ◽  
Advanced Stages

Abstract: To summarize actual knowledge on epidemiology, etiology, pathology, clinical apparence and treatment of ocular surface squamous neoplasias. We summarize up-to-date literature on conjunctival intraepithelial neoplasia and invasive squamous cell carcinoma and present some own cases. Ocular surface squamous neoplasia is the most common malignant ocular surface tumor and the third most common ocular malignancy following malignant melanoma and lymphoma. In spite of its low malignant potential, in advanced stages it may reduce visual acuity significantly or even the eye globe has to be removed. In case of metastasis it may also be life-threatening. As local recurrences of ocular surface squamous neoplasias may occur, knowledge of intra- and postoperative adjuvant treatment options are indispensable and regular control examinations are necessary. Identification and adequate treatment of ocular surface squamous neoplasias are necessary in order to avoid its progression and to prevent recurrences. Orv Hetil. 2017; 158(51): 2011–2022.

Systemic neoadjuvant chemotherapy in non-resectable invasive squamous cell carcinoma of ocular surface

2021 ◽  
pp. 112067212110143
Author(s):  
Rachna Meel ◽  
Rebika Dhiman ◽  
Seema Kashyap ◽  
Sahil Agrawal ◽  
Neelam Pushker ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Ocular Surface ◽  
Tumor Imaging ◽  
Case Series ◽  
Surgical Excision ◽  
Response To Treatment ◽  
High Morbidity ◽  
Complete Regression ◽  
Invasive Squamous Cell Carcinoma ◽  
Retrospective Case

Background/objectives: The conventional modality for management of advanced invasive ocular surface squamous neoplasia (OSSN) (AJCC grade T4 and T3 with fornicial involvement) is surgical excision which is not only challenging in terms of ability to achieve tumor free margins and tissue reconstruction but also has high morbidity. We describe the use of systemic neoadjuvant chemotherapy (NAC) in cases of advanced invasive OSSN. Subjects/methods: This is a retrospective case series. Five cases of histopathologically proven advanced OSSN that were challenging to manage with surgical excision or required exenteration were treated with NAC. Demographic details, previous treatment history, location and extent of tumor, imaging findings, number of cycles and duration of NAC, response to treatment, and final outcome on follow-up were noted. Results: A remarkable response to NAC was seen in 4/5(80%) cases. Complete regression was seen in 2/5, partial regression in 2/5, and no response in 1/5 cases. In 75% (3/4) cases who showed response to NAC, minimal or no surgery was required. Exenteration was avoided in 2/3 cases with orbital extension. Conclusion: NAC appears to be an exciting option for management of surgically challenging cases of invasive OSSN and may be helpful in avoiding orbital exenteration. However, more studies are required to explore this treatment option.

Sign in / Sign up

Export Citation Format

Share Document