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 Giant Ocular Surface Squamous Neoplasia Wrapping Almost the Whole Cornea: A Case Report

2020 ◽  
Vol 42 (2) ◽  
pp. 94-96
Author(s):  
Poonam Shrestha ◽  
Mukesh Pandey
Keyword(s):  
Ocular Surface ◽  
Histopathological Examination ◽  
Promising Result ◽  
Intraepithelial Neoplasia ◽  
Surgical Excision ◽  
Treatment Modalities ◽  
Ocular Surface Squamous Neoplasia ◽  
History Of ◽  
Grade 3 ◽  
Clinical Pictures

Ocular surface squamous neoplasia (OSSN) includes the dysplastic lesions involving the epithelium of conjunctiva and cornea with various clinical pictures. Histopathological examination of the excised tissue is the benchmark for diagnosis. Surgery, chemotherapy, immunotherapy are the various treatment modalities which in combination shows promising result. We present here a case of 83 years old female patient with history of fleshy mass covering the cornea and the patient was diagnosed clinically as ocular surface squamous neoplasia. Patient underwent surgical excision of the mass followed by cryotherapy. Histopathological examination revealed conjunctival intraepithelial neoplasia of grade 3. Six months after treatment the patient is completely tumor free with no recurrence.

Development of invasive disease in 433 women treated for vulvar, vaginal or perianal intraepithelial neoplasia

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 5043-5043
Author(s):  
M. K. Fehr ◽  
K. J. Dedes ◽  
S. Heinzl ◽  
M. D. Mueller ◽  
M. Baumann ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Case Series ◽  
Intraepithelial Neoplasia ◽  
Invasive Disease ◽  
Malignant Potential ◽  
Initial Diagnosis ◽  
Laser Evaporation ◽  
High Grade

5043 Background: The incidence of intraepithelial neoplasia (IN) of the lower anogenital tract is increasing. Due to small case-series, the malignant potential of treated high-grade IN is not well defined and risk factors for progression are not established. Methods: Patients with IN of the vulva (VIN), vagina (VAIN) and perianal skin (PAIN) were identified in the electronic databases of three university colposcopy clinics. Inclusion criteria were biopsy proven IN grade 2–3 (high-grade) and no history of vaginal, vulvar or anorectal cancer. Excluded were patients with the diagnosis of invasive disease within one year from initial diagnosis of IN. Results: 442 patients were identified from 1977 to 2005 with a mean follow up of 69.9 ± 56.1 months. Initial diagnosis was VIN III in 75.3%, VIN II in 17.2%, VAIN II in 4.3%, VAIN III in 2%, and PAIN II/III in 1.1% of patients. Mean age at initial diagnosis was 47.1 ± 14.1 (range, 18–102). Initial treatment was biopsy and laser evaporation in 61.5%, surgical excision in 32.8%, and other locally destructive methods in 3.1% of patients. 9 patients refused any treatment (2.0%). In the 433 treated patients, recurrent disease (e.g. diagnosed >1 year after initial diagnosis) occurred in 32.2%. In patients with a follow up longer than 5 years, 14.4 % were still experiencing recurrences. In multivariate analysis, immunosuppression (OR: 2.33, 95% CI 1.06–5.06, p = 0.035) was associated with recurrence but not smoking, age or histological grade. Progression to invasive disease occurred in 3.8% of treated patients within a mean time of 7.9 ± 6.8 years (range, 1.3–24.5). In multivariate analysis, immunosuppression (OR:3.31, 95% CI 1.01–10.93, p = 0.049) and smoking (OR:3.12, 95% CI 1.07–9.08, p = 0.037) were independent risk factors for progression. Conclusions: Anogenital IN is a chronic disease in a substantial proportion of patients. The malignant potential is remarkably high despite repeated treatments. Therefore, long lasting surveillance is mandatory, especially in immunosuppressed or smoking patients. No significant financial relationships to disclose.

Risk Factors for Failure in Hammertoe Surgery

2020 ◽  
Vol 41 (5) ◽  
pp. 562-571 ◽  
Author(s):  
Rachel H. Albright ◽  
Moiz Hassan ◽  
Jacob Randich ◽  
Robert O’Keefe ◽  
Erin E. Klein ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cox Regression ◽  
Elective Surgery ◽  
Case Series ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Cox Regression Analysis ◽  
First Ray ◽  
Pip Joint

Background: Hammertoe correction is perhaps the most common elective surgery performed in the foot, yet rates of symptomatic recurrence and revision surgery can be high. In this study, we aimed to identify patient and provider risk factors associated with failure after hammertoe surgery. Methods: Consecutive patients with a minimum of 6 months’ follow-up undergoing hammertoe surgery within a single, urban foot and ankle practice between January 1, 2011, and December 31, 2013, served as the basis of this retrospective cohort study. Cox regression analysis was used to identify important predictor variables obtained through chart and radiographic review. One hundred fifty-two patients (311 toes) with a mean age of 60.8 ± 11.2 years and mean follow-up of 29.5 ± 21.2 months were included. Results: Statistically significant predictors of failure were having a larger preoperative transverse plane deviation of the digit (hazard ratio [HR], 1.03 for each degree; P < .001; 95% CI, 1.02, 1.04), operating on the second toe (vs third or fourth) (HR, 2.23; P = .003; 95% CI, 1.31, 3.81), use of a phalangeal osteotomy to reduce the proximal interphalangeal (PIP) joint (HR, 2.77; P = .005; 95% CI, 1.36, 5.64), and using less common/conventional operative techniques to reduce the PIP joint (HR, 2.62; P = .03; 95% CI, 1.09, 6.26). Concomitant performance of first ray surgery reduced hammertoe recurrence by 50% (HR, 0.51; P = .01; 95% CI, 0.30, 0.87). Conclusion: We identified risk factors that may provide guidance for surgeons during preoperative hammertoe surgery consultations. This information may better equip patients with appropriate postoperative expectations when contemplating surgery. Level of Evidence: Level III, retrospective case series.

Periocular intravascular papillary endothelial hyperplasia: A retrospective study

2021 ◽  
pp. 112067212110481
Author(s):  
Azza MY Maktabi ◽  
Abdullah I Almater ◽  
Hind M Alkatan
Keyword(s):  
Thrombus Formation ◽  
Case Series ◽  
Excisional Biopsy ◽  
Vascular Lesions ◽  
Intravascular Papillary Endothelial Hyperplasia ◽  
Retrospective Case ◽  
Management Options ◽  
Papillary Endothelial Hyperplasia ◽  
Age Range

Introduction: Intravascular papillary endothelial hyperplasia (IPEH) is a rare proliferation of endothelial cells with uncertain etiology related to thrombus formation. Diagnosis is usually confirmed histopathologically. This condition has been previously described in the periocular region but not in the conjunctiva. Methods: It is a retrospective case series in which we evaluated seven patients with histopathologically confirmed IPEH cases. Data regarding the demographics, clinical presentation, radiological description, histopathological features including any IHC staining, suspected underlying vascular etiology, management options, and follow up outcome were collected. Results: A total of seven cases of histologically confirmed IPEH were included. Five out of seven patients were male (71.4%). The age range was between 6 and 69 years with a median age of 36 years. Three cases involved the eyelid (42.8%) and another three were found in the conjunctiva (42.8%). Pre-existing underlying vascular lesions were observed in all patients, five malformations (mostly lymphatic-venous) and two conjunctival hemorrhagic lymphangiectasis. All cases were treated with excisional biopsy with no signs of recurrence within an average of 7 months follow up. Conclusions: Periocular IPEH is a rare tumor that is likely to coexist with underlying vascular lesions and thrombus formation. We are reporting its existence in the conjunctiva for the first time. Therefore, pathologists should be aware of the histopathological spectrum of this lesion.

scholarly journals Prevalence of hypothyroidism among patients with isthmus-preserved thyroid lobectomy

2018 ◽  
Vol 46 (9) ◽  
pp. 3819-3823 ◽  
Author(s):  
Abdulwahid M. Salih
Keyword(s):  
Histopathological Examination ◽  
Benign Lesion ◽  
Case Series ◽  
Follicular Carcinoma ◽  
Retrospective Case ◽  
Post Surgery ◽  
Thyroid Lobectomy ◽  
Case Series Study ◽  
Series Study

Objective To investigate the prevalence of hypothyroidism following thyroid lobectomy with isthmus preservation. Methods This retrospective, case series study included patients who had undergone thyroid lobectomy with preserved isthmus that was reversed onto the contralateral lobe. Neck ultrasound was performed in all patients and the patients were followed for 2 years. Results Out of 170 patients enrolled into the study, three were excluded due to preoperative hypothyroidism and one due to isthmusectomy; of the remaining 166 included in the final analyses, 139 patients (83.7%) were female, 27 (16.3%) were male, and patient age ranged between 17 and 77 years. The indication for intervention was thyroid swelling in 141 patients (84.9%). Final diagnoses following histopathological examination comprised benign lesion in 145 cases (87.3%), malignancy (follicular carcinoma and papillary thyroid carcinoma) in 12 cases (7.2%) and thyroiditis in nine cases (5.4%). During the 2-year post-surgery follow-up, 165 patients (99.4%) were euthyroid and one patient (0.6%) developed hypothyroidism. Conclusion Postoperative hypothyroidism following thyroid lobectomy appears to be very rare when the isthmus is preserved and reversed onto the contralateral lobe.

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 Management of Ocular Surface Squamous Neoplasia in Association with Fungal Keratitis in a HIV Positive Individual

2021 ◽  
Author(s):  
Prabhakar Singh ◽  
Abhishek Gupta ◽  
Richa Gupta
Keyword(s):  
Risk Factors ◽  
Ocular Surface ◽  
Comprehensive Evaluation ◽  
Topical Steroid ◽  
Fungal Keratitis ◽  
Hiv Positive ◽  
Ocular Surface Squamous Neoplasia ◽  
Steroid Abuse ◽  
Positive Individual ◽  
Vegetative Matter

Ocular Surface Squamous Neoplasia (OSSN) co-existent with fungal keratitis in an immunodeficient individual has rarely been talked about in literature. Risk factors for fungal keratitis are trauma with vegetative matter, topical steroid abuse, poor ocular surface, corneal anaesthesia, systemic immunosuppression, etc., and for OSSN a major risk factor is immunodeficiency. In current report, patient had multiple risk factors. This report highlights the management of HIV positive 42-year-old male with OSSN and fungal keratitis. A comprehensive evaluation helps clinician decide on treatment priority and achieve good clinical outcome.

scholarly journals Invasive conjunctival melanoma mimicking ocular surface squamous neoplasia: a case series

2020 ◽  
pp. bjophthalmol-2019-315393 ◽  
Author(s):  
Beatrice Gallo ◽  
Caroline Thaung ◽  
Gordon Hay ◽  
Amit K Arora ◽  
Victoria ML Cohen ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Ocular Surface ◽  
De Novo ◽  
Case Series ◽  
Intraepithelial Neoplasia ◽  
Histopathological Diagnosis ◽  
Conjunctival Melanoma ◽  
Ocular Surface Squamous Neoplasia

BackgroundConjunctival melanoma is the second most common conjunctival malignant tumour after squamous cell carcinoma, usually arising from primary acquired melanosis and less commonly from a conjunctival naevus or de novo. We report four cases of conjunctival melanoma masquerading as ocular surface squamous neoplasia.MethodsFour patients (2 females and 2 males; mean age 60.7 years; range 41–72 years) were referred for suspicious conjunctival lesions. In all cases, the lesions had a perilimbal location, were non-pigmented (cases 1 and 3) or mildly pigmented (cases 2 and 4), had a fleshy (cases 1, 2 and 4) or papillomatous (case 3) appearance and involved the corneal surface. In each case, our main clinical differential diagnosis included conjunctival intraepithelial neoplasia and squamous cell carcinoma. All four patients underwent an excisional biopsy with double freeze-thaw cryotherapy and alcohol keratoepitheliectomy.ResultsIn all four cases, the histopathological diagnosis was of invasive conjunctival melanoma with extension to the deep surgical margins. Adjuvant therapy consisting of strontium-90 β radiotherapy (all 4 patients) and topical Mitomicyn C (patient 2) was administered.ConclusionConjunctival melanoma can clinically resemble ocular surface squamous neoplasia. Clinical impressions therefore need to be confirmed histopathologically.

scholarly journals Management of Ocular Surface Squamous Neoplasia with Topical and Intralesional Interferon Alpha 2B in Mexicans

2018 ◽  
Vol 10 (2) ◽  
pp. 143-150 ◽  
Author(s):  
Ángel Nava-Castañeda ◽  
Joaquín Hernández-Orgaz ◽  
Lilia Garnica-Hayashi ◽  
Alberto Ansart ◽  
Gonzalo Matus ◽  
...  
Keyword(s):  
Interferon Alpha ◽  
Ocular Surface ◽  
Treatment Time ◽  
Case Series ◽  
Demographic Variables ◽  
Histopathological Diagnosis ◽  
Ocular Surface Squamous Neoplasia ◽  
Interferon Alpha 2B ◽  
The Mean

Introduction: Ocular surface squamous neoplasia (OSSN) is the most common nonpigmented ocular surface neoplasm and it can originate from the conjunctiva and/ or corneal epithelium. Since the rate of recurrence after surgical excision is high, chemotherapeutic and immunotherapeutic agents such as interferon alpha-2b (IFN α-2b) have been used for its treatment. Objective: Our objective is to describe the demographic variables of patients with OSSN treated with IFN α-2b and to describe the outcomes of its use in Mexican patients, treated between 2011 and 2017 at Instituto de Oftalmología Fundación Conde de Valenciana. Materials and Methods: This is a non-randomized retrospective interventional case series. We reviewed the files of patients older than 18 years, with clinical and/or histopathological diagnosis of OSSN, treated with IFN α-2b alone or in combination with surgery, with a minimum of 6 months follow-up. We studied demographic variables, such as gender, age, eye affected and associated risks factors; we also studied the type of therapy with interferon (topical, intralesional and/or associated with surgery), time of treatment, time of follow up, recurrences and complications. Results: A total of 39 patients were included. The mean age of diagnosis was 61 ± 16 years and OSSN was more frequent in males (64.1% of cases). Most of the cases (43.6%) had no identifiable risk factors. The mean time of IFN α-2b treatment was 5 ± 2 months, being higher in the intralesional group (6.5 months) than in the topical group (4.2 months). The clinical resolution with the use of IFN α-2b was evidenced between 0.5 and 10 months, being achieved in 87.1% of the patients. Conclusions: The use of IFN α-2b is effective for the treatment of OSSN with a high success rate (87.1%) and a low incidence of relapse (5 cases), with no reported complications during follow up.  

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