Treatment of ocular surface squamous neoplasia: Case reportof ocular surface squamous neoplasia: Case report

摘要

Saxc5xbeetakAim: Ocular surface squamous neoplasia (OSSN) is a term that encompasses a wide and varied spectrum of very rare dysplastic disease of cornea and conjunctiva, ranging from conjunctival intraepithelial neoplasia (CIN), carcinoma in situ (CIS) to invasive squamous cell carcinoma (SCC) of conjunctiva and/or cornea. Case report: In our case report, we present squamous cell carcinoma of the conjunctiva and cornea in a 78-year old man. Our diagnostic algorithm included: slit lamp and fundus examination, gonioscopy, impression cytology (IC) andmagnetic resonance imaging (MRI). The patient underwentsurgical excisional biopsy of the lesion and intraoperativecryotherapy of the cut conjunctival edges and sclera-conjuctiva base region. Following surgical therapy, we started topical 0.02 % (0.2 mg/ml) Mitomycin C (MMC) application daily for 14 days. Control excisional biopsy of conjunctival edge and abrasion of involved cornea were performed following the last day of topical chemotherapy. Our controlexcisional biopsyrevealed tumor positive corneal tissue and the second cycle of topical 0.04 % (0.4 mg/ml) MMCchemotherapy wasstarted for next 3 weeks. The patient has been followed-up for 20 months through monthlyxc3xa2xe2x82xacxe2x80x9cbased visits, with no recurrence of the disease. Conclusions: OSSN is a surgical challenge requiring a specialized xc3xa2xe2x82xacxc2x98no-touchxc3xa2xe2x82xacxe2x84xa2 (NT) technique. In our case, the combination of surgical excision with intraoperative cryotherapy and topical chemotherapy with 0.02 % MMC application for 14 days, completed with second cycle of topical 0.04 % MMC drops for the next 21 days given the positive control biopsy, proved to be a good choice for eradication of OSSN with accurate further monitoring of the patient.