Topical Therapy for Ocular Surface Squamous Neoplasia

2013 ◽  
Vol 06 (02) ◽  
pp. 154
Author(s):  
Derek Bitner ◽  
Donald U Stone ◽  
◽  
Keyword(s):  
Ocular Surface ◽  
Topical Therapy ◽  
Genetic Defect ◽  
Surgical Excision ◽  
Treatment Modalities ◽  
Ocular Surface Squamous Neoplasia ◽  
Recurrence Rates ◽  
Interferon Alpha 2B ◽  
Complete Surgical Excision ◽  
Treatment Paradigm

Ocular surface squamous neoplasia, or OSSN, is a clinical spectrum often encountered in ophthalmic practice. The incidence varies depending on the population being studied, but is more common among less pigmented males with increased occupational ultraviolet (UV) exposure as well as among those living in closer proximity to the equator. The incidence increases with age; in younger patients, the presence of OSSN is often associated with another underlying disorder, such as the genetic defect in xeroderma pigmentosum, or immunosuppression as is seen in patients infected with HIV. The challenges of complete surgical excision in patients with extensive tumors, in addition to the high recurrence rates in some series, led to a search for nonsurgical treatment modalities. In addition to avoiding surgery, topical agents may offer the additional benefit of treating clinically unapparent disease. Due to the theoretic advantages of topical chemotherapy, multiple agents have been used in both the primary and adjuvant treatment of OSSN. Mitomycin, interferon alpha-2b, and 5-fluorouracil have all been utilized with success; mitomycin may invoke a greater risk for limbal stem cell failure, and interferon is well tolerated and effective but more expensive. Future developments in imaging and chemotherapeutics will likely continue to alter the treatment paradigm for ocular surface tumors.

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.

scholarly journals Management of ocular surface squamous neoplasia: Bowman Club Lecture 2021

2021 ◽  
Vol 6 (1) ◽  
pp. e000842
Author(s):  
Osmel Peter Alvarez ◽  
Mike Zein ◽  
Anat Galor ◽  
Carol L Karp
Keyword(s):  
Ocular Surface ◽  
Treatment Options ◽  
Anterior Segment ◽  
Surgical Excision ◽  
Interferon Α ◽  
Long Term Effects ◽  
Ocular Surface Squamous Neoplasia ◽  
Recurrence Rates ◽  
Medical Treatments ◽  
Additional Costs

The gold-standard treatment for ocular surface squamous neoplasia (OSSN) has traditionally been surgical excision with wide margins and a no-touch technique. However, surgery may be associated with several unfavourable sequelae, as well as significant recurrence rates if margins are positive. In recent years, topical chemotherapy with 5-fluorouracil, interferon α−2b and mitomycin C have emerged as valuable agents capable of effectively treating OSSN with varying adverse effects. These medical treatment options usually present additional costs to the patient but can allow patients to avoid surgery with fewer long-term effects. Anterior segment high-resolution optical coherence tomography is an excellent tool for diagnosing and monitoring OSSN and can be a useful aid for both surgical and medical treatments of OSSN.

scholarly journals Treatment of Ocular Surface Squamous Neoplasia with Interferon Alpha-2b

2020 ◽  
Vol 35 (4) ◽  
pp. 247-251
Author(s):  
Zahid Kamal Siddiqui ◽  
Farooq Ahmad ◽  
Farah Huma ◽  
Shahid Tarar ◽  
Amir Yaqoob
Keyword(s):  
General Hospital ◽  
Interferon Alpha ◽  
Confidence Level ◽  
Ocular Surface ◽  
Armed Forces ◽  
Ocular Surface Squamous Neoplasia ◽  
Recurrence Rates ◽  
Interferon Alpha 2B ◽  
Ifn Alpha ◽  
Patient Department

Purpose: To study the efficacy and safety and of Interferon (IFN) alpha 2b for Ocular Surface Squamous Neoplasia (OSSN). Study Design: Non - Comparative Interventional Study. Place of Study:  Mayo Hospital Lahore, Lahore General Hospital, Armed Forces Institute of Ophthalmology, Rawalpindi, Pakistan Duration of Study: study was conducted between the period of October 2010 to August 2016. Material and methods: Patients with suspected conjunctival growth underwent incisional biopsy after admission from out patient department. After confirming the diagnosis of Ocular Surface Squamous Neoplasia (OSSN), on Histopathology, case was inducted in the study. Intralesional / peri-lesional Interferon(IFN)  Alpha-2b was given to the patients weekly along with interferon Alpha-2b topical drops four times daily, for Three 03 months. These patients were followed in Out Patient Department of respective hospitals and examined. For resolution or recurrence of lesion for at least three (03) months. And final results were compiled. Results: Study was conducted at Mayo Hospital Lahore, Armed Force institute of Ophthalmology, Rawalpindi and Lahore General Hospital, Lahore.  Total Sample size of 90 (Ninety) Patients is estimated by using 95% confidence level, 10% absolute precision with expected percentage of Ocular surface squamous neoplasia as 91.6%.    n= (Z1-α/2)2 X P X q / d2 Z1-α2 = Confidence level 95% = 1.96 P = Prevalence 91.6% q= 1-P d= Absolute precision 10%   Out of these Twenty-nine, 29 were females and Fifty Nine, 59 were male patients. Non-Probability consecutive sampling was done. All patients tolerated and responded well to the treatment. There was recurrence in Eight 8 eyes. Conclusion: For the management of Ocular surface squamous Neoplasia IFN alpha 2 b is safe and effective choice with low recurrence rates.

Zosteriform Nevus Comedonicus

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 2609-2612
Author(s):  
Babbita S ◽  
Thillaikkarasi A ◽  
Sathyanarayanana R ◽  
Narasimhalu CRV ◽  
Sulochana Sonti
Keyword(s):  
Topical Therapy ◽  
Treatment Options ◽  
Neck Region ◽  
Surgical Excision ◽  
Hair Follicles ◽  
Treatment Modalities ◽  
Developmental Defect ◽  
Linear Distribution ◽  
Head And Neck Region ◽  
Typical Morphology

Nevus comedonicus is an uncommon cutaneous developmental defect of follicular apparatus characterized by unilateral and linear distribution of bundles of dilated hair follicles filled with keratin plugs. It is usually seen on the head and neck region, trunk and upper arm. This condition may be present at birth or can occur later in life. The term nevus comedonicus is a misnomer as there are no true comedones and is better termed as follicular keratotic nevus. It is also known as nevus zoniforme or nevus acneiformis unilateralis. There are two types of nevus comedonicus, namely inflammatory and non-inflammatory (non-pyogenic). When nevus comedonicus is manifested with other extracutaneous symptoms, it is termed as nevus comedonicus syndrome. Diagnosis is mainly clinical, based on history and typical morphology. As the disease runs a benign course, no aggressive treatment is required. Patients seek treatment, especially for cosmetic purposes and inflammatory type of lesions. Various treatment modalities like topical therapy, surgical excision, lasers are available and treatment options are individualized based on the size and extent of the lesion. We herein present a case of unilateral nevus comedonicus with no systemic associations in a 30-year-old female on her lower limb which is not a common site of occurrence.

Inflammatory myofibroblastic tumour of the conjunctiva masquerading as ocular surface squamous neoplasia

2020 ◽  
pp. 112067212097361
Author(s):  
Manpreet Singh ◽  
Manu Saini ◽  
Debajyoti Chatterjee ◽  
Aditi Mehta ◽  
Manpreet Kaur ◽  
...  
Keyword(s):  
Amniotic Membrane ◽  
Ocular Surface ◽  
Surgical Excision ◽  
Excision Biopsy ◽  
Inflammatory Myofibroblastic Tumour ◽  
Complete Surgical Excision ◽  
Oral Steroids ◽  
Rare Site ◽  
The Right

A 63-year-male had painless, progressive, yellowish-pink, immobile conjunctival mass with prominent feeder vessels in the right eye of 1-year duration. The rest of the ophthalmic examination was unremarkable. MRI showed no extension into orbit or extraocular muscles. An excision biopsy with the amniotic membrane patch was performed. Histopathology confirmed inflammatory myofibroblastic tumour (IMT) with SMA and calponin positivity on immunohistochemistry. Complete surgical excision, amniotic membrane, and oral steroids provided long-term relief from recurrence. The conjunctiva is a rare site for IMT, and IMT should be kept in the differentials for atypical cases of ocular surface neoplasia.

scholarly journals Orbital Schwannoma

2020 ◽  
Vol 81 (04) ◽  
pp. 376-380
Author(s):  
Mark B. Chaskes ◽  
Mindy R. Rabinowitz
Keyword(s):  
Surgical Excision ◽  
Treatment Goals ◽  
Resonance Imaging ◽  
Recurrence Rates ◽  
Complete Excision ◽  
Representative Case ◽  
Presenting Symptoms ◽  
Complete Surgical Excision ◽  
Imaging Characteristics ◽  
Magnetic Resonance Imaging Mri

AbstractOrbital schwannomas are rare neoplasms of the orbit. The presenting symptoms are often nonspecific. Classic imaging characteristics seen on magnetic resonance imaging (MRI) and orbital ultrasound can be useful to help aid in the diagnosis of orbital schwannoma. When diagnosed, the goal of treatment is complete surgical excision. The location of the tumor within the orbit dictates which surgical approach would provide the best exposure. When complete excision is achieved, recurrence rates are very low.This article addresses the etiology, patient population, presentation, natural history, and differential diagnosis of orbital schwannomas. Imaging characteristics and histopathologic subtypes are reviewed. Treatment goals, approaches, and specialties involved in the management of these patients is discussed. Finally, a representative case is presented.

scholarly journals Axillary Nodal Metastasis of Operated Gallbladder Carcinoma – First Remote Site of Aggression.

2021 ◽  
Author(s):  
Manu Vats ◽  
Lovenish Bains ◽  
Pawan Lal ◽  
Shramana Mandal
Keyword(s):  
Surgical Excision ◽  
Port Site ◽  
Treatment Modalities ◽  
Axillary Lymph Nodes ◽  
R0 Resection ◽  
Axillary Lymph ◽  
Port Site Metastasis ◽  
Axillary Metastasis ◽  
Complete Surgical Excision ◽  
Axillary Lymphadenectomy

Abstract Background: Gallbladder cancer is a very aggressive type of biliary tract cancer. The only curative treatment is complete surgical excision of the tumour. However, even after surgery, there is still a risk of recurrence of the cancer.Case summary: A 63-year-old gentleman presented with the complaint of a non-healing ulcer at epigastrium for the last 1 month, after having undergone a laparoscopic cholecystectomy at a private centre 4 months ago. Investigations confirmed the diagnosis of epigastric port site metastasis from a primary from gall bladder adenocarcinoma. After undergoing completion radical cholecystectomy with wide local excision of the epigastric ulcer, he received 6 cycles of concurrent chemoradiotherapy. Eighteen months later, he presented to us with bilateral axillary swellings. Investigations confirmed bilateral axillary metastasis. He then underwent bilateral axillary lymphadenectomy (Level 3). However, PET scan after 6 months showed widespread metastasis and the patient succumbed to the illness 1 month later.Conclusion: Axillary metastasis probably occurs due to the presence of microscopic systemic metastasis at the time of development of port site metastasis. An R0 resection of the malignancy is the only viable option for effective therapy. The present case highlights the rare involvement of bilateral axillary lymph nodes as the first distant metastatic site with no evidence of disease in the locoregional site. However, the prognosis after metastasis remains dismal despite multiple treatment modalities.

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