Topical mitomycin C treatment in corneal and conjunctival intraepithelial neoplasia: A case report
Year 2021,
Volume: 5 Issue: 9, 992 - 994, 01.09.2021
Asena Keleş Şahin
,
Aslıhan Uzun
,
Havva Erdem
Abstract
Corneal and conjunctival intraepithelial neoplasia is a slowly progressive ocular surface lesion with low malignant potential. Owing to the high recurrence rates, cryotherapy or topical chemotherapy is used with surgical treatment. In this paper, we report the histopathologic findings and treatment of a case of intraepithelial neoplasia that began in the conjunctiva and progressed to the cornea. A 75-year-old woman presented with complaints of redness, irritation and lacrimation in her left eye for around 1 month. Slit-lamp examination revealed a papilliform mass on the nasal conjunctiva along with involvement of the adjacent corneal epithelium. Conjunctival excisional biopsy showed a moderate epithelial dysplasia. Topical 0.04% mitomycin C was administered 4 times daily for 3 weeks. No recurrence was observed in the following 18 months.
References
- 1. Kao AA, Galor A, Karp CL, Abdelaziz A, Feuer WJ, Dubovy SR. Clinicopathologic correlation of ocular surface squamous neoplasms at Bascom Palmer Eye Institute: 2001 to 2010. Ophthalmology. 2012;119(9):1773-6. doi: 10.1016/j.ophtha.2012.02.049.
- 2. Gichuhi S, Ohnuma S, Sagoo MS, Burton MJ. Pathophysiology of ocular surface squamous neoplasia. Exp Eye Res. 2014;129:172-82. doi: 10.1016/j.exer.2014.10.015.
- 3. Hamam R, Bhat P, Foster CS. Conjunctival/corneal intraepithelial neoplasia. Int Ophthalmol Clin. 2009;49(1):63-70. doi: 10.1097/IIO.0b013e3181924ec3.
- 4. Scholz SL, Thomasen H, Reis H, Möller I, Darawsha R, Müller B, et al. Frequent TERT promoter mutations in ocular surface squamous neoplasia. Invest Ophthalmol Vis Sci. 2015;56(10):5854-61. doi: 10.1167/iovs.15-17469.
- 5. Pe'er J. Ocular surface squamous neoplasia: evidence for topical chemotherapy. Int Ophthalmol Clin. 2015;55(1):9-21. doi: 10.1097/IIO.0000000000000050.
- 6. Frucht-Pery J, Rozenman Y, Pe'er J. Topical mitomycin-C for partially excised conjunctival squamous cell carcinoma. Ophthalmology. 2002;109(3):548-52. doi: 10.1016/s0161-6420(01)00967-8.
- 7. Giaconi JA, Karp CL. Current treatment options for conjunctival and corneal intraepithelial neoplasia. Ocul Surf. 2003;1:66-73.
- 8. Galor A, Karp CL, Oellers P, Kao AA, Abdelaziz A, Feuer W, et al. Predictors of ocular surface squamous neoplasia recurrence after excisional surgery. Ophthalmology. 2012;119(10):1974-81. doi: 10.1016/j.ophtha.2012.04.022.
- 9. Tabin G, Levin S, Snibson G, Loughnan M, Taylor H. Late recurrences and the necessity for long-term follow-up in corneal and conjunctival intraepithelial neoplasia. Ophthalmology. 1997;104(3):485-92. doi: 10.1016/s0161-6420(97)30287-5.
- 10. Besley J, Pappalardo J, Lee GA, Hirst LW, Vincent SJ. Risk factors for ocular surface squamous neoplasia recurrence after treatment with topical mitomycin C and interferon alpha-2b. Am J Ophthalmol. 2014;157(2):287-93. doi: 10.1016/j.ajo.2013.10.012.
- 11. McKelvie PA, Daniell M. Impression cytology following mitomycin C therapy for ocular surface squamous neoplasia. Br J Ophthalmol. 2001;85(9):1115-9. doi: 10.1136/bjo.85.9.1115.
- 12. Frucht-Pery J, Rozenman Y. Mitomycin C therapy for corneal intraepithelial neoplasia. Am J Ophthalmol. 1994;117(2):164-8. doi: 10.1016/s0002-9394(14)73072-7.
- 13. Soysal HG, Yazar Z. The efficacy of postoperative topical mitomycin C in the treatment of conjunctival epithelial neoplasia. Turk J Ophthalmol. 2008;38(6):464-7.
- 14. Khong JJ, Muecke J. Complications of mitomycin C therapy in 100 eyes with ocular surface neoplasia. Br J Ophthalmol. 2006;90(7):819-22. doi: 10.1136/bjo.2005.086850.
- 15. Dudney BW, Malecha MA. Limbal stem cell deficiency following topical mitomycin C treatment of conjunctival-corneal intraepithelial neoplasia. Am J Ophthalmol. 2004;137(5):950-1. doi: 10.1016/j.ajo.2003.10.048.
Korneal ve konjonktival intraepitelyal neoplazide topikal mitomisin C tedavisi: olgu sunumu
Year 2021,
Volume: 5 Issue: 9, 992 - 994, 01.09.2021
Asena Keleş Şahin
,
Aslıhan Uzun
,
Havva Erdem
Abstract
Korneal ve konjonktival intraepitelyal neplazi, düşük malignite potansiyeli olan yavaş ilerleyen bir oküler yüzey lezyonudur. Yüksek nüks oranları nedeniyle kriyoterapi veya topikal kemoterapi cerrahi tedavi ile birlikte kullanılmaktadır. Çalışmamızda, konjonktivada başlayıp korneaya ilerleyen intraepitelyal neoplazili olgunun histopatolojik bulgularını ve tedavisini sunduk. Yetmiş beş yaşında kadın hasta yaklaşık 1 aydır devam eden sol gözünde kızarıklık, batma ve sulanma şikayetleri ile kliniğe başvurdu. Biyomikroskobik muayenede; nazal konjonktivada papilliform kitle ve bitişik kornea epitelinde tutulum mevcuttu. Konjonktival eksizyonel biyopsi sonucu orta derecede epitelyal displazi olarak raporlandı. Hastaya günde 4 defa, 3 hafta süresince topikal %0,04 mitomisin C uygulandı. Takip eden 18 aylık sürede nüks gelişmedi.
Supporting Institution
Yazarlar tarafından bu çalışma için finansal destek alınmamıştır
References
- 1. Kao AA, Galor A, Karp CL, Abdelaziz A, Feuer WJ, Dubovy SR. Clinicopathologic correlation of ocular surface squamous neoplasms at Bascom Palmer Eye Institute: 2001 to 2010. Ophthalmology. 2012;119(9):1773-6. doi: 10.1016/j.ophtha.2012.02.049.
- 2. Gichuhi S, Ohnuma S, Sagoo MS, Burton MJ. Pathophysiology of ocular surface squamous neoplasia. Exp Eye Res. 2014;129:172-82. doi: 10.1016/j.exer.2014.10.015.
- 3. Hamam R, Bhat P, Foster CS. Conjunctival/corneal intraepithelial neoplasia. Int Ophthalmol Clin. 2009;49(1):63-70. doi: 10.1097/IIO.0b013e3181924ec3.
- 4. Scholz SL, Thomasen H, Reis H, Möller I, Darawsha R, Müller B, et al. Frequent TERT promoter mutations in ocular surface squamous neoplasia. Invest Ophthalmol Vis Sci. 2015;56(10):5854-61. doi: 10.1167/iovs.15-17469.
- 5. Pe'er J. Ocular surface squamous neoplasia: evidence for topical chemotherapy. Int Ophthalmol Clin. 2015;55(1):9-21. doi: 10.1097/IIO.0000000000000050.
- 6. Frucht-Pery J, Rozenman Y, Pe'er J. Topical mitomycin-C for partially excised conjunctival squamous cell carcinoma. Ophthalmology. 2002;109(3):548-52. doi: 10.1016/s0161-6420(01)00967-8.
- 7. Giaconi JA, Karp CL. Current treatment options for conjunctival and corneal intraepithelial neoplasia. Ocul Surf. 2003;1:66-73.
- 8. Galor A, Karp CL, Oellers P, Kao AA, Abdelaziz A, Feuer W, et al. Predictors of ocular surface squamous neoplasia recurrence after excisional surgery. Ophthalmology. 2012;119(10):1974-81. doi: 10.1016/j.ophtha.2012.04.022.
- 9. Tabin G, Levin S, Snibson G, Loughnan M, Taylor H. Late recurrences and the necessity for long-term follow-up in corneal and conjunctival intraepithelial neoplasia. Ophthalmology. 1997;104(3):485-92. doi: 10.1016/s0161-6420(97)30287-5.
- 10. Besley J, Pappalardo J, Lee GA, Hirst LW, Vincent SJ. Risk factors for ocular surface squamous neoplasia recurrence after treatment with topical mitomycin C and interferon alpha-2b. Am J Ophthalmol. 2014;157(2):287-93. doi: 10.1016/j.ajo.2013.10.012.
- 11. McKelvie PA, Daniell M. Impression cytology following mitomycin C therapy for ocular surface squamous neoplasia. Br J Ophthalmol. 2001;85(9):1115-9. doi: 10.1136/bjo.85.9.1115.
- 12. Frucht-Pery J, Rozenman Y. Mitomycin C therapy for corneal intraepithelial neoplasia. Am J Ophthalmol. 1994;117(2):164-8. doi: 10.1016/s0002-9394(14)73072-7.
- 13. Soysal HG, Yazar Z. The efficacy of postoperative topical mitomycin C in the treatment of conjunctival epithelial neoplasia. Turk J Ophthalmol. 2008;38(6):464-7.
- 14. Khong JJ, Muecke J. Complications of mitomycin C therapy in 100 eyes with ocular surface neoplasia. Br J Ophthalmol. 2006;90(7):819-22. doi: 10.1136/bjo.2005.086850.
- 15. Dudney BW, Malecha MA. Limbal stem cell deficiency following topical mitomycin C treatment of conjunctival-corneal intraepithelial neoplasia. Am J Ophthalmol. 2004;137(5):950-1. doi: 10.1016/j.ajo.2003.10.048.