Corneal involvement was found in 38% of 287 cases of conjunctival squamous cell neoplasia cin. Topical 1% 5fu was administered four times daily for 4 weeks one course. Backgroundaims conjunctival squamous cell carcinoma cscc is the most frequent malignant tumour of the conjunctiva, with scarce recurrence and infrequent metastasis. Commonly, squamous conjunctival neoplasia will contain characteristic corkscrewshaped blood vessels.
Squamous cell carcinoma is more common in males 75% than in females 25%. Squamous cell dysplasia and carcinoma of the conjunctiva. Sep 01, 2002 read treatment of conjunctival squamous cell carcinoma with topical cidofovir, american journal of ophthalmology on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. Diagnosis and treatment of basal cell and squamous cell carcinoma. Intraepithelial and invasive squamous cell carcinoma of. Shields et al 12 recently reported a case series of 5 patients with intraocular invasion of conjunctival squamous cell carcinoma. Biologically, these tumors appear to be locally aggressive and should be differentiated histopathologically from the conventional squamous cell carcinoma of the conjunctiva, which carries a better prognosis. Material and methods patient oe, a 90yearold female, was admitted for a tumor mass in the bulbar conjunctiva of the right eye, which was painless, and displacing the eyeball inferotemporally. Feline conjunctival melanoma 46 cases in the coplow database. Aimsto assess changes in incidence of conjunctival squamous cell carcinoma over a 22 year period in tanzania and to analyse possible reasons for change. This investigation revealed 146 cases of primary squamous cell dysplasia and carcinoma of the conjunctiva in 143 patients between 1980 and 2011, leading to an incidence rate of 0.
Recurrence with free margins is from 5 to 15% compared to 50 to 60% when margins are affected. Translucent limbal mass is associated with dilated afferent and efferent conjunctival. Squamous cell carcinoma of the conjunctiva is the endstage of a spectrum of disease referred to as ocular surface squamous neoplasia ossn. Worldwide, conjunctival squamous cell carcinoma scc is an uncommon disease, the incidence of which varies geographically from 0. Defined by abnormal malignant appearing epithelial cells replacing the entire conjunctival stratified squamous epithelial layer. Treating squamous carcinomas of the conjunctiva and cornea. Ocular surface squamous neoplasia among hivinfected. Second, to investigate the incidence of orbital exenteration during followup. Methods eight patients affected by conjunctival squamous cell carcinoma three recurrent cases, three incompletely excised, and two untreated cases were treated with 1% 5fu eye drops. Squamous cell carcinomas of the conjunctiva are either limbal or, less often, truly conjunctival. Anatomic distribution of feline primary ocular neoplasia n 2599 82 % 12.
Scc is the most common malignancy of the conjunctiva in the us, with a yearly incidence of 12. It appears as a white or yellowpink nodule on the eye surface in the front of the eye where it can easily be seen. A 34yearold male was diagnosed with squamous cell carcinoma scc involving the right lower bulbar and palpebral conjunctiva with extension to the proximal lacrimal drainage system. Squamous cell carcinoma of the conjunctiva with extraocular. All patients showed excellent evolution without recurrence. Ocular surface squamous neoplasia is a term that describes neoplastic changes of the cornea and conjunctiva ranging from squamous dysplasia to invasive squamous cell carcinoma scc. Patients notice a white or yellowwhite tumor on the surface of the eye often with extension onto the cornea.
Aggressive conjunctival squamous cell carcinoma in a patient. The squamous cell carcinoma of the conjunctiva is a rare tumour. The cornea is rarely the primary site for neoplasms, but it is frequently involved secondarily in conjunctival tumors such as squamous cell carcinoma and malignant melanoma. Conjunctival squamous cell carcinoma with corneal stromal. Feline conjunctival and lid squamous cell carcinoma severe lymphocytic inflammation. A 94yearold woman without known systemic diseases developed a mass in her right conjunctiva. The case of a 76 years old male patient with a conjunctival squamous cell carcinoma is presented. Conjunctival squamous cell carcinoma conjuctival squamous cell carcinoma is a cancer on the surface of the eye and is usually found in older caucasian white skinned patients. Patient oe, a 90yearold female, was admitted for a tumor mass in the bulbar conjunctiva of the right eye, which was painless, and. The main clinical manifestation was discomfort, pain and redness in the eye. Extensive conjunctival squamous cell carcinoma of the left eye.
Squamous cell carcinoma of the conjunctiva semantic scholar. American joint committee on cancer ajcc ajcc cancer staging manual 8th ed. Conjunctival squamous cell carcinoma wills eye hospital. The purpose of this report is to present the findings in a case of squamous cell carcinoma scc of the conjunctiva which was the initial sign of systemic cancers. Conclusions over the longterm followup, cryosurgery following excision is a successful method in the treatment of conjunctival intraepithelial tumours and invasive squamous cell carcinoma of. Squamous cell carcinoma most commonly appears as a firm, smooth, or. Conjunctival squamous cell carcinoma in tanzania europe. Massive corneal and conjunctival squamous cell carcinoma. In a case of squamous cell carcinoma of conjunctiva and cornea, invasion beyond the epithelium and bowmans layer does not occur primarily despite its. Surgical excision was performed with 2mm tumor free margins documented histologically and doublefreeze cryotherapy was applied 360 for inhibition of tumor recurrence. Histopathology revealed conjunctival squamous dysplasia in 26%, carcinoma in situ in 39%, and squamous cell carcinoma in 36% of the patients. A black man aged 61 years with aids presented in our institution in 20 with extensive leftsided orbital soft tissue necrosis and exposure of deep orbital structures, with left eye le destruction caused by squamous cell carcinoma scc figure 1a.
Pages in category carcinoma the following 26 pages are in this category, out of 26 total. Pdf to retrospectively study 26 patients with squamous cell carcinoma scc of the ocular surface to determine pathological and clinical. Ocular surface squamous neoplasia ossn ossn includes a wide spectrum of dysplastic changes of the squamous epithelium of the ocular surface conjunctiva and cornea. This study deals with the likelihood of intraocular invasion by conjunctival squamous cell carcinoma which is uncommon. A case of squamous cell carcinoma of conjunctiva as. Pdf ocular surface squamous neoplasia is a term that describes. The clear cell variant makes up a distinct minority of squamous cell carcinomas. This cme activity will discuss the latest treatment approaches for conjunctival squamous cell carcinoma and conjunctival intraepithelial neoplasia. Scc of the conjunctiva is a rare tumor mainly affecting the elderly age group. In summary, we report an advanced case of morpheaform basal cell carcinoma of the conjunctiva with intraocular spread and secondary glaucoma, which, to our knowledge, has not been reported. It consists of a broad range of pathologic squamous cell dysplasia including. This chapter presents the diagnosis and treatment for conjunctival squamous cell carcinoma scc, which occurs in the pug and the english bulldog. The invasive conjunctival squamous cell carcinoma scc of the eyeball is a malignant tumor that invades only the conjunctiva and rarely the eyeball and the tissue of the orbit. The patient was lost to followup and returned 2 months later with a rapidly enlarged lesion of the eyelid and anterior orbit, with radiographic evidence of orbital invasion.
To evaluate the outcome of surgical management of advanced squamous cell carcinoma scc of the conjunctiva american joint committee cancerclassification iii and the rate of recurrences after treatment during followup. Mucoepidermoid carcinoma is a relatively rare tumor of the conjunctiva that needs to be distinguished from squamous cell carcinoma because of its more aggressive behavior and its tendency to recur. Aim to evaluate the efficacy of topical 5fluorouracil 5fu alone, without concurrent surgery or radiotherapy, for the treatment of conjunctival squamous cell carcinoma. Ocular surface squamous neoplasia ossn is the most common type of primary ocular surface neoplasm. The patient had limbal and corneal involvement temporally, as well as scleral invasion with intraocular spread. He had developed a mass on his entire right upper eyelid, and biopsy revealed a moderately differentiated scc. Although frequently underdiagnosed, squamous cell carcinoma is the most.
Biopsy revealed moderately differentiated squamous cell carcinoma with keratin pearls. Intraepithelial squamous carcinoma also known as conjunctival intraepithelial neoplasia, or conjunctival intraepithelial neoplasia, previously known as bowens disease and invasive squamous cell carcinoma of the conjunctiva are histologically differentiated according to the invasion of epithelial basement membrane. Sep 19, 2016 conjunctival tumors range from benign to malignant and lifethreatening. Depending on the histopathologic findings, conjunctival squamous neoplasia. The patient had suffered from severe psoriasis since childhood, for which he was on longstanding systemic cyclosporine, topical tacrolimus, and previous. Metastatic squamous cell carcinoma of the conjunctiva. This study suggests that topical conjunctival chemotherapy with 1% 5fu may be useful, at least as adjunctive therapy, in the treatment of conjunctival squamous cell carcinoma.
Squamous cell papillomas are typically associated with human papillomavirus hpv while for others the cause is unknown. Squamous carcinoma and dysplasia of the conjunctiva and cornea. Conjunctival squamous cell carcinoma scc arising from an anophthalmic socket is quite rare, with few reports in the english literature. Altered gene expression in conjunctival squamous cell carcinoma.
Conjunctival squamous cell carcinoma following psoriasis. Determining the correct diagnosis is of great therapeutic and prognostic significance, as sebaceous. A case of conjunctival mucoepidermoid carcinoma in australia. Demographics, etiology, and behavior of conjunctival squamous.
Squamous cell carcinoma is the most frequent malignant tumour of the conjunctiva. Squamous cell carcinoma of the conjunctiva is usually a slowly progressive neoplasm that rarely invades the eye or orbit. Ocular surface squamous neoplasia is a disease of the elderly l having predilection for the interpalpebral area mostly the corneoscleral limbus. Histopathologic examination showed a moderately differentiated squamous cell carcinoma. The main risk factors for both are exposure to solar ultraviolet radiation outdoors, hivaids, human. Conjunctival tumors range from benign to malignant and lifethreatening. Ocular and periocular tumors in cats richard r dubielzig. Conjunctival squamous cell carcinoma clinical atlas of. Squamous cell carcinoma of the conjunctiva springerlink. Squamous carcinoma and intraepithelial neoplasia of the. Conjunctival squamous cell carcinoma due to longterm.
Hereditary factors, exposure to uv sunlight andor chronic inflammation may contribute to the development of conjunctival andor third eyelid tel scc. Squamous cell carcinoma of the conjunctiva is most common in caucasian individuals. Two extremes of the clinical spectrum of conjunctival. For example squamous cell carcinoma can affect the eyelids palpebral carcinoma, the conjunctiva conjunctival carcinoma, and the cornea in situ carcinoma. Methodsretrospective analysis of records from a tanzanian pathology department serving north and central tanzania from 1976 to 1997. Conjunctival intraepithelial neoplasia cin, characterised by dysplasia involving a partial to full thickness of the epithelium, and invasive squamous cell carcinoma scc of the conjunctiva belong to a single disease spectrum termed ocular surface squamous neoplasia ossn. Four rare forms of this type of neoplasm are described and illustrated. Squamous conjunctival neoplasia tends to be found between the eyelids interpalpebral space, and at the limbus border of the white sclera and clear cornea. Apr 22, 2015 no patients had died from conjunctival squamous cell carcinoma or a precursor stadium.
The epidemiology of conjunctival squamous cell carcinoma in. T2weighted mri demonstrated total left orbital invasion figure. In situ carcinoma of the conjunctiva may be simply and successfully treated with surgical excision and cryotherapy. Rapidly progressive conjunctival squamous cell carcinoma. Adjunctive radiotherapy with strontium90 in the treatment of conjunctival squamous cell carcinoma. Introduction and epidemiology squamous cell carcinoma of the conjunctiva is the endstage of a spectrum of disease referred to as ocular surface squamous neoplasia ossn. Conjunctival squamous cell carcinoma conjunctival scc and corneal intraepithelial neoplasia comprise what are called ocular surface squamous cell neoplasias. In the former case they are classified as carcinoma in situ cis lesions or conjunctival corneal intraepithelial neoplasia ccin and in the latter case invasive squamous cell carcinoma scc. As part of a larger investigation of cancer in uganda, we conducted a casecontrol study of conjunctival squamous cell carcinoma in adults presenting at hospitals in kampala. She was referred to our hospital 5 months after the onset. Association with squamous cell carcinoma of the conjunctiva charles ateenyi agaba thesis for doctoral degree ph. Cancer of the conjunctiva squamous cell carcinoma of the.
Primary basal cell carcinoma of the conjunctiva with. Excision and cryosurgery in the treatment of conjunctival. The most common type of nonmelanocytic tumors include ocular surface squamous neoplasia and lymphoma. Research article open access low frequency of human. Full text the full text of this article is available as a pdf 170k. Likewise, melanoma can occur in the eyelids rebhun, 1998, the.
A 59yearold man who had used an ocular prosthesis for 40 years had not removed the ocular prosthesis at all during the last 5 years. Patients with squamous cell carcinoma of the conjunctiva tend to be elderly, with an average age of 60 years. Resemblance to common conditions such as pterygium and pinguecula may result in a. Seven patients 27 % suffered recurrent ocular surface squamous neoplasia ossn. Atypia throughout full thickness of epithelium conjunctival intraepithelial neoplasia with individual tumor cells or nests extending into underlying stroma. Aim to evaluate the clinical features, treatment results, and recurrence rates in patients with either intraepithelial or invasive squamous cell carcinoma of the conjunctiva methods retrospective analysis of 60 cases 22 conjunctival intraepithelial and 38 invasive squamous cell carcinomas to determine patterns of clinical presentation, aetiological factors, and treatment results. The main risk factors for both are exposure to solar ultraviolet radiation outdoors, hivaids, human papilloma virus and. To describe 4 cases of conjunctival squamous cell carcinoma scc with corneal stromal invasion. Jan 01, 2000 massive corneal and conjunctival squamous cell carcinoma. Pdf adjunctive radiotherapy with strontium90 in the.
Squamous cell carcinoma is a malignancy often arising in patients with longstanding histories of alcohol and tobacco use and associated comorbidities, whereas esophageal adenocarcinoma is. Clinical outcome of advanced squamous cell carcinoma of the. Conjunctival squamous cell carcinoma is a malignancy of the ocular surface. He had a history of biopsyproven conjunctival scc in le, diagnosed in 2010. This is believed to be due to occupational exposure to sunlight. Methodseight patients affected by conjunctival squamous cell carcinoma three recurrent cases, three incompletely excised, and two untreated cases were treated with 1% 5fu eye drops. Cancer of the conjunctiva squamous cell carcinoma of.
Barbazetto, lee, and abramson 1 interesting observations are made on three patients using photodynamic therapy pdt to reduce tumor size on the surface of the eye. A squamous cell papilloma is a generally benign papilloma that arises from the stratified squamous epithelium of the skin, lip, oral cavity, tongue, pharynx, larynx, esophagus, cervix, vagina or anal canal. There is also a nodular type that is circumscribed, rapidly growing, and invasive. Ossn is a malignant disease of the eyes that can lead to loss of vision and, in severe cases, death. Ocular surface squamous neoplasia is an uncommon disease, with an incidence of 1.
Ocular surface squamous neoplasia ossn ranges from areas of conjunctival intraepithelial neoplasia cin to large invasive squamous cell carcinoma scc. First described in 1976, conjunctival mucoepidermoid carcinoma is a rare and highly aggressive variant of conjunctival squamous cell carcinoma which can often require enucleation or orbital exenteration. Ocular, orbital and periorbital neoplastic conditions of. The purpose of this study is to describe the clinical and pathological characteristics of this neoplasm and to identify the prognostic factors for recurrence and metastasis in a cancer hospital in peru. Treatment of conjunctival squamous cell carcinoma with. Pdf squamous cell carcinoma of the conjunctiva researchgate. Aimto evaluate the efficacy of topical 5fluorouracil 5fu alone, without concurrent surgery or radiotherapy, for the treatment of conjunctival squamous cell carcinoma. If these malignant appearing stratified squamous epithelial cells extend through the epithelial basement membrane and invade the substantia propria of the conjunctiva, it is characterized as invasive squamous cell carcinoma. Since this type more commonly extends beneath the conjunctival epithelium, nodular tumors exhibit increased metastatic potential. The cancer of the squamous epithelium was labeled as epithelioma by rudolph. Apr 01, 2005 treatment of conjunctival squamous cell carcinoma with photodynamic therapy treatment of conjunctival squamous cell carcinoma with photodynamic therapy hirst, lawrence w. Conjunctival squamous cell carcinoma and conjunctival. This report illustrates the clinical management of squamous cell carcinoma.
Background conjunctival squamous cell carcinoma is the most common nonpigmented malignancy of the ocular surface. Pathophysiology of ocular surface squamous neoplasia. The importance of achieving tumorfree surgical margins in excised ossn is profound, with. Conjunctiva tumor an overview sciencedirect topics. Conjunctival squamous cell carcinoma in tanzania europe pmc.
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