1/70. Ocular surface neoplasia masquerading as chronic blepharoconjunctivitis.PURPOSE: To present the clinical characteristics and difficulties in the diagnosis of various ocular surface malignancies mimicking features of chronic blepharoconjunctivitis and to summarize the current therapeutic approach and prognosis of patients. methods: Six patients with slowly evolving signs of persistent inflammation underwent a conjunctival biopsy after a prolonged course of medical treatment. The medical records of the patients were reviewed. RESULTS: Histopathologic examination of the biopsy specimens revealed intraepithelial squamous neoplasia (one patient), invasive squamous cell carcinoma (one patient), sebaceous carcinoma (two patients), and conjunctival lymphoma (two patients). CONCLUSION: Although uncommon, ocular surface malignancies may involve the conjunctiva diffusely and present as chronic conjunctivitis. A high index of suspicion and an early histopathologic examination are essential to not delay diagnosis.- - - - - - - - - - ranking = 1keywords = neoplasia (Clic here for more details about this article) |
2/70. The 1998 Pan American Lecture. Intraocular invasion of conjunctival squamous cell carcinoma in five patients.PURPOSE: To report five patients with intraocular invasion of conjunctival squamous cell carcinoma and to make recommendations regarding clinical recognition and treatment of this condition. methods: The authors reviewed the clinical records and pathology slides on five patients who had intraocular invasion of conjunctival squamous cell carcinoma, and they describe the presenting features and histopathology in these cases. RESULTS: Intraocular invasion of conjunctival squamous cell carcinoma occurred in older patients who had one or more recurrences of a previously excised conjunctival epithelial tumor located near the comeoscleral limbus. The intraocular recurrence often was heralded by the onset of low-grade inflammation and secondary glaucoma, simulating a granulomatous iridocyclitis. A white mass generally was observed in the anterior chamber angle. Histopathologic examination revealed an ingrowth of malignant epithelial cells through the limbus with diffuse involvement of the anterior segment of the eye. The reported patients were managed by modified enucleation (standard enucleation with excision of affected conjunctival tissue). Metastatic disease did not develop in any of the patients. CONCLUSIONS: The onset of signs of uveitis and glaucoma and a white mass in the anterior chamber angle in a patient with prior excision of a conjunctival squamous cell neoplasm tumor should raise suspicion of intraocular recurrence of conjunctival squamous cell carcinoma. Most affected patients require enucleation or subtotal orbital exenteration. The prognosis is good.- - - - - - - - - - ranking = 0.0016671422804158keywords = neoplasm (Clic here for more details about this article) |
3/70. Conjunctival epithelial neoplasias in organ transplant patients receiving cyclosporine therapy.PURPOSE: To report two cases of conjunctival epithelial neoplasias occurring after long-term systemic cyclosporine therapy in organ transplant recipients. methods: Case report. Each patient underwent an excision of an extensive limbal conjunctival lesion, followed by a histopathologic analysis. RESULTS: Histopathologic examination results revealed a carcinoma in situ and a squamous cell carcinoma in patients 1 and 2, respectively. recurrence occurred in patient 1, who needed topical mitomycin C 0.02% treatment. No recurrence was observed in patient 2 after a follow-up of 24 months. CONCLUSION: To our knowledge, these are the first reported cases of its kind after longterm systemic cyclosporine therapy. Further studies will be needed to determine the exact role of cyclosporine in the induction of conjunctival epithelial neoplasias and the need for regular ophthalmologic examination of transplant recipients.- - - - - - - - - - ranking = 1.2keywords = neoplasia (Clic here for more details about this article) |
4/70. Treatment of conjunctival intraepithelial neoplasia with topical drops of mitomycin C.PURPOSE: To evaluate the efficacy and risks of complications of topical mitomycin C (MMC) for small-size conjunctival intraepithelial neoplasia (CIN). methods: Eight patients with clinically diagnosed CIN <8 mm were included in the study. patients received topical drops of MMC, 0.02-0.04%, 4 times daily for 14 days. retreatment was done when lesions were not eliminated or recurred after the first treatment. RESULTS: Three patients remained disease free after one course of MMC application. retreatment was done in four patients because of lesions that decreased in size but were not eliminated, and for regrowth in one case. After retreatment, the lesions were eradicated in four patients, whereas in one patient, the treatment failed, and the lesion was surgically excised. The complications of MMC use included mild conjunctival hyperemia in two patients and mild allergy in one patient, which resolved after discontinuation of the treatment. CONCLUSION: Application of topical MMC is an effective treatment for most but not all cases of small-size CIN.- - - - - - - - - - ranking = 1keywords = neoplasia (Clic here for more details about this article) |
5/70. Conjunctival intraepithelial neoplasia presenting as corneal ulcer.PURPOSE: To report a case of conjunctival intraepithelial neoplasia presenting as corneal ulcer. METHOD: Case report of a 28-year-old man who presented with sudden onset of pain, redness, and watering in the right eye. Examination of right cornea revealed deep stromal infiltrate inferonasally. Adjacent to the infiltrate and straddling the inferonasal limbus, a reddish well-defined sessible lesion with prominent blood vessels was seen. After corneal scraping for microbiological evaluation, the patient was treated with frequent instillation of ciprofloxacin hydrochloride 0.3% eyedrops. RESULTS: Corneal scraping revealed no microorganisms. Infiltrate resolved promptly after excision of the lesion. Histopathologic evaluation of the excised lesion revealed conjunctival intraepithelial neoplasia. CONCLUSIONS: This case highlights the fact that conjunctival intraepithelial neoplasia at the limbus may present as corneal ulcer. This ulcer could have occurred secondary to a dellen formation and epithelial breakdown predisposing to a corneal ulcer.- - - - - - - - - - ranking = 1.4keywords = neoplasia (Clic here for more details about this article) |
6/70. Mucoepidermoid carcinoma of the conjunctiva: a series of three cases.OBJECTIVE: To detail the clinical presentation and outcomes of currently available treatments for mucoepidermoid carcinoma of the conjunctiva (MCC). DESIGN: Retrospective noncomparative case series. PARTICIPANTS: Three patients ranging from 40 to 63 years of age with MCC participated. INTERVENTION: Excisional biopsies and various therapies were performed. MAIN OUTCOME MEASURES: Clinical and surgical outcomes were measured. RESULTS: Patient 1 is a 55-year-old man with right temporal MCC. He underwent two local excisions with adjuvant cryotherapy and has had no recurrence at 31 months follow-up. Patient 2 is a 63-year-old man with right temporal MCC who underwent fractionated iodine 125 plaque radiotherapy. He had a recurrence approximately 8 months after plaque treatment and subsequently underwent enucleation of the right eye. Clinical follow-up examinations revealed no further recurrence at 17 months. Patient 3 is a 40-year-old woman treated for right MCC with carbon dioxide laser with recurrence at 3 weeks. She subsequently underwent radiation treatment with the development of regional lymph node metastases 16 months later. CONCLUSIONS: MCC is a rare neoplasm that displays an extraordinary capacity for aggressive local invasion. This series of three case reports demonstrates the high recurrence rate of MCC and the response of this tumor to different current modalities of treatment. Extended follow-up is required with this tumor because distant metastases can occur very late.- - - - - - - - - - ranking = 0.0016671422804158keywords = neoplasm (Clic here for more details about this article) |
7/70. Detection, aetiology and management of conjunctival intraepithelial neoplasia.Conjunctival intraepithelial neoplasia (CIN) are considered to be the third most common ocular tumour and the most common tumour of the ocular surface. Due to their malignant potential, they must be carefully differentially and promptly treated. A recurrence rate of approximately 30% leads to the need for monitoring of patients even after successful treatment. This article presents several cases of CIN and reviews their histopathology, aetiology, appearance, differential diagnosis and management. Typical patient presentations and prognoses are also discussed.- - - - - - - - - - ranking = 1keywords = neoplasia (Clic here for more details about this article) |
8/70. 5-fluorouracil for the treatment of intraepithelial neoplasia of the conjunctiva and cornea.OBJECTIVE: To evaluate the efficacy of pulse dosing of topical 5-fluorouracil (5-FU) in the treatment of conjunctival and corneal intraepithelial neoplasia. DESIGN: Prospective, noncomparative case series. PARTICIPANTS: Seven patients with histologic evidence of intraepithelial neoplasia were identified by conjunctival biopsy or tumor excision. methods: Seven patients with a minimum of 7 months of follow-up were treated with pulsed dosing of 1% 5-FU. Topical 1% 5-FU was administered four times daily for 2 to 4 days for each cycle. The number of initial treatment cycles was two to six, with the time between cycles being 30 to 45 days. MAIN OUTCOME MEASURES: The presence or absence of clinically evident intraepithelial neoplasia was evaluated after each treatment interval. patients were also monitored for adverse reactions to the use of topical 5-FU. RESULTS: Four patients remain disease free with a mean follow-up of 18.5 months (range, 7-36 months) with no additional treatment after the initial treatment cycles (mean, 3.75 cycles; range, 2-5 cycles). Three patients had recurrence of disease after the initial treatment cycles. Two patients were treated with additional cycles for recurrent disease (six cycles in one patient and five cycles in the other patient) and are free of disease at 20 and 21 months after treatment, respectively. One patient had persistent disease despite treatment with topical 5-FU and was treated with topical mitomycin C with resolution of the disease without recurrence for 16.5 months. No adverse reactions to pulse dose treatment with topical 5-FU were noted. CONCLUSIONS: Pulsed dosing with 1% topical 5-FU for the treatment of conjunctival and corneal intraepithelial neoplasia, alone or as an adjunct to excision of bulky disease, is a well-tolerated and effective method of treatment.- - - - - - - - - - ranking = 1.6keywords = neoplasia (Clic here for more details about this article) |
9/70. Conjunctival T-cell lymphoma caused by human T-cell lymphotrophic virus infection.PURPOSE: To examine the cause of adult T-cell leukemia/lymphoma. methods: We examined a conjunctival biopsy from a 29-year-old Jamaican man who developed bilateral conjunctival masses. adult T-cell leukemia/lymphoma was diagnosed using routine histology, immunohistochemistry, electron microscopy, microdissection, and the polymerase chain reaction. RESULTS:Histopathologic examination revealed a conjunctival lymphoma. Clonality of the T-cell receptor gamma gene and human T-cell lymphotrophic virus gag gene were detected in the malignant cells. The demonstration of the human T-cell lymphotrophic virus gene and the rearrangement of the T-cell receptor gene in this neoplasm provide proof that human T-cell lymphotrophic virus is the cause of this conjunctival T-cell lymphoma. CONCLUSION: Human T-cell lymphotrophic virus is the cause of adult T-cell leukemia/lymphoma, an aggressive malignancy of CD4 lymphocytes.- - - - - - - - - - ranking = 0.0016671422804158keywords = neoplasm (Clic here for more details about this article) |
10/70. Primary intraepithelial sebaceous gland carcinoma of the palpebral conjunctiva.Sebaceous gland carcinoma usually arises from meibomian or Zeis glands deep within the eyelid, but it can rarely arise within the conjunctival epithelium without a deep component. We describe a woman with a history of chronic blepharoconjunctivitis unresponsive to topical medications. Examination disclosed confluent papillary hypertrophy of the upper palpebral conjunctiva and deposits of white flaky material. Tarsoconjunctival punch biopsy revealed intraepithelial sebaceous gland carcinoma. Management consisted of frozen section-controlled complete tumor excision with removal of the entire posterior lamella of the right upper eyelid, cryotherapy to the margins, and reconstruction. Histopathologic analysis confirmed primary sebaceous gland carcinoma localized to the conjunctival epithelium without involvement of underlying meibomian or Zeis glands or the caruncle. patients with unexplained chronic unilateral blepharoconjunctivitis or papillary hypertrophy of the palpebral conjunctiva should be considered for biopsy to rule out neoplasia, even when there is no sign of an underlying eyelid mass.- - - - - - - - - - ranking = 0.2keywords = neoplasia (Clic here for more details about this article) |
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