Clinical and pathological characteristics of ocular surface squamous neoplasia in an Asian population
- 432 Downloads
In order to evaluate clinical and pathological characteristics of ocular surface squamous neoplasia (OSSN) in Asian population.
Medical records were reviewed of 30 eyes of 30 Korean patients who underwent en-bloc excision and biopsy for tumors in the corneal and conjunctival epithelium in the suspicion of OSSN.
Tumors developed predominantly in males (21/30 patients, 70 %) at the mean age of 64.8 years (range: 39–82 years). Histologic examination revealed that 11 cases were squamous cell carcinoma (SCC), eight were conjunctival or corneal intraepithelial neoplasm (CIN) with dysplastic cells in the epithelium, eight simple hyperplasia, and three inflammatory lesions. The majority of SCC (9/11 eyes, 81.8 %) involved the nasal conjunctiva and cornea, while one of eight eyes (12.5 %) with CIN was located at the nasal side. Vascularization was combined in all eyes with SCC, in two of eight (25 %) with CIN, in two of three with inflammation, and in none with hyperplasia. Both cornea and conjunctiva were involved in ten of 11 eyes (90.9 %) with SCC, in six of eight (75 %) with CIN, in two of eight (25 %) with hyperplasia, and in two of three (66.7 %) with inflammation. When classified based on clinical appearance, seven of 11 eyes (63.6 %) with SCC were papilliform sessile masses, and four of eight (50 %) with CIN showed gelatinous growth onto the surface. All lesions were treated with en-bloc excision and cryotherapy. Recurrence occurred in seven out of 19 patients (36.8 %) with SCC or CIN during the mean follow-up of 30.0 months—four patients with SCC and three with CIN. Hyperplasia or lesions with inflammation did not recur. The recurrence rate was not associated with histological diagnosis of a lesion. However, the use of the postoperative chemotherapy including topical mitomycin C or interferon α 2b had a significant negative correlation with the recurrence.
In total, 36.7 % of tumors in the corneal and conjunctival epithelium were SCC, and 26.7 % were CIN. Recurrence occurred in 36.8 % of patients with SCC or CIN after primary excision and cryotherapy. The use of postoperative chemotherapy was a significant factor negatively affecting the recurrence.
KeywordsConjunctival intraepithelial neoplasm Corneal intraepithelial neoplasm Ocular surface squamous neoplasia Squamous cell carcinoma
- 2.Babar TF, Khan MN, Hussain M, Shah SA, Khan MY, Khan MD (2007) Spectrum of ocular surface squamous neoplasia. J Coll Phys Surg Pak 17:344–346Google Scholar
- 7.Pizzarello LD, Jakobiec FA (1978) Bowen’s disease of the conjunctiva: a misnomer. In: Jakobiec FA (ed) Ocular and adnexal tumors. Aesculapius, Birmingham, pp 553–571Google Scholar
- 10.Ni C, Searl SS, Kriegstein HJ, Wu BF (1982) Epibulbar carcinoma. Int Ophthalmol Clin 22:1–33Google Scholar
- 13.Lee GA, Williams GA, Hirst LW, Green AC (1994) Risk factors in the development of ocular surface epithelia dysplasia. Ophthalmology 110:525–527Google Scholar
- 22.Esquenazi S, Fry CL, Holley E (2009) Treatment of biopsy proved conjunctival intraepithelial neoplasia with topical interferon alfa-2b. Br J Ophthalmol 28:986–988Google Scholar