Luise Grajewski, Christiane Kneifel, M. Wösle, I. Ciernik, Lothar Krause
Introduction: Local recurrence of conjunctival melanoma (CM) is common after excision. Local radiotherapy is an effective adjuvant treatment option, and brachytherapy with ruthenium (106Ru) is one such option. Thus, herein, we aimed to describe our experience with and the clinical results of postexcision adjuvant 106Ru plaque brachytherapy in patients with CM. Methods: Nineteen patients (8 men and 11 women) received adjuvant brachytherapy with a 106Ru plaque after tumor excision. The mean adjuvant dose administered was 109 Gy (range, 80–134 Gy), and a depth of only 2.2 mm was targeted because the tumor had been excised. A full ophthalmological examination including visual acuity testing, slit-lamp examination, and indirect ophthalmoscopy was performed before therapy and at every postoperative follow-up. The mean follow-up period was 62 months (range, 2–144 months). Results: Three patients developed a recurrence in a nontreated area, either at the conjunctiva bulbi or the conjunctiva tarsi. None of the patients developed a recurrence in the treated area. The local control rate was 84% (16/19). Conclusion: 106Ru plaque brachytherapy is an effective adjuvant treatment to minimize the risk of local recurrence after excision of a CM. Patients have to be followed-up regularly and carefully for the early detection of recurrence.
{"title":"Adjuvant brachytherapy with ruthenium-106 to reduce the risk of recurrence of conjunctival melanoma after excision","authors":"Luise Grajewski, Christiane Kneifel, M. Wösle, I. Ciernik, Lothar Krause","doi":"10.1159/000539684","DOIUrl":"https://doi.org/10.1159/000539684","url":null,"abstract":"Introduction: Local recurrence of conjunctival melanoma (CM) is common after excision. Local radiotherapy is an effective adjuvant treatment option, and brachytherapy with ruthenium (106Ru) is one such option. Thus, herein, we aimed to describe our experience with and the clinical results of postexcision adjuvant 106Ru plaque brachytherapy in patients with CM.\u0000Methods: Nineteen patients (8 men and 11 women) received adjuvant brachytherapy with a 106Ru plaque after tumor excision. The mean adjuvant dose administered was 109 Gy (range, 80–134 Gy), and a depth of only 2.2 mm was targeted because the tumor had been excised. A full ophthalmological examination including visual acuity testing, slit-lamp examination, and indirect ophthalmoscopy was performed before therapy and at every postoperative follow-up. The mean follow-up period was 62 months (range, 2–144 months).\u0000Results: Three patients developed a recurrence in a nontreated area, either at the conjunctiva bulbi or the conjunctiva tarsi. None of the patients developed a recurrence in the treated area. The local control rate was 84% (16/19). \u0000Conclusion: 106Ru plaque brachytherapy is an effective adjuvant treatment to minimize the risk of local recurrence after excision of a CM. Patients have to be followed-up regularly and carefully for the early detection of recurrence.\u0000","PeriodicalId":506981,"journal":{"name":"Ocular Oncology and Pathology","volume":"38 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141355438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Timothy Kalas, Dimitrios Vagenas, Luke Maccheron, Nicholas Toalster
Introduction: This study examined the distribution of histopathological disease severity amongst a cohort of patients treated for clinically suspected ocular surface squamous neoplasia and evaluated the relationship between various patient and clinical factors and the severity of pathological grade as well as treatment outcomes. Methods: A retrospective cohort study of demographic and clinicopathological factors of 150 patients clinically diagnosed with suspected ocular surface squamous neoplasia who underwent excision of lesion with histopathological diagnosis. Results: The study included 125 cases; the mean age at diagnosis was 64 years (SD = 11.26). 74% of cases were histologically confirmed as ocular surface squamous neoplasia. Pathological distribution was conjunctival intraepithelial neoplasia I (13.6%), conjunctival intraepithelial neoplasia II (16.8%), conjunctival intraepithelial neoplasia III (21.6%), carcinoma in situ (21.6%), and squamous cell carcinoma (2.4%). Lesion appearance was leukoplakic (18%), gelatinous (15%), dysplastic (11%), vascular (6%), papilliform (2%), nodular (2%). Lesion location was nasal (43%), temporal (42%), and superior or inferior (14%). Recurrence occurred in 7 cases (5.6%). A significant association was found between presence of leukoplakia and pathological grade (p = 0.05). Conclusions: Ocular surface squamous neoplasia is most frequently diagnosed in conjunctival intraepithelial neoplasia III and carcinoma in situ stages, and treatment outcomes are usually favourable.
{"title":"Clinicopathological Correlates of Ocular Surface Squamous Neoplasia","authors":"Timothy Kalas, Dimitrios Vagenas, Luke Maccheron, Nicholas Toalster","doi":"10.1159/000538174","DOIUrl":"https://doi.org/10.1159/000538174","url":null,"abstract":"Introduction: This study examined the distribution of histopathological disease severity amongst a cohort of patients treated for clinically suspected ocular surface squamous neoplasia and evaluated the relationship between various patient and clinical factors and the severity of pathological grade as well as treatment outcomes. Methods: A retrospective cohort study of demographic and clinicopathological factors of 150 patients clinically diagnosed with suspected ocular surface squamous neoplasia who underwent excision of lesion with histopathological diagnosis. Results: The study included 125 cases; the mean age at diagnosis was 64 years (SD = 11.26). 74% of cases were histologically confirmed as ocular surface squamous neoplasia. Pathological distribution was conjunctival intraepithelial neoplasia I (13.6%), conjunctival intraepithelial neoplasia II (16.8%), conjunctival intraepithelial neoplasia III (21.6%), carcinoma in situ (21.6%), and squamous cell carcinoma (2.4%). Lesion appearance was leukoplakic (18%), gelatinous (15%), dysplastic (11%), vascular (6%), papilliform (2%), nodular (2%). Lesion location was nasal (43%), temporal (42%), and superior or inferior (14%). Recurrence occurred in 7 cases (5.6%). A significant association was found between presence of leukoplakia and pathological grade (p = 0.05). Conclusions: Ocular surface squamous neoplasia is most frequently diagnosed in conjunctival intraepithelial neoplasia III and carcinoma in situ stages, and treatment outcomes are usually favourable.","PeriodicalId":506981,"journal":{"name":"Ocular Oncology and Pathology","volume":"85 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140736230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nipun Kumar, R. Meel, S. Bakhshi, D. Pushpam, N. Pushker, M. Bajaj, S. Kashyap, S. Sen, S. Pathy, Sanjay Sharma
Introduction Eyelid sebaceous gland carcinoma (SGC) is an aggressive malignancy. Surgical excision is the standard treatment for non-metastatic eyelid SGC. This study aimed to evaluate treatment outcomes with use of neoadjuvant chemotherapy (NACT) and any change in ease/difficulty of surgical treatment in such cases. Methods This was a prospective interventional study conducted over 24 months period. Histopathologically confirmed cases without any systemic metastasis were included. Clinico-demographic details were collected for 30 patients. 10 patients received NACT using cisplatin and 5-FU. Tumour response was evaluated, using RECIST criteria. An ease of surgery questionnaire was used to assess difficulty of surgical treatment before and after NACT. Results Of the 30 patients evaluated for recruitment, 37% had recurrent SGC and 72% had advanced tumour stage. 10 patients were recruited for NACT. There was Partial response in 80% and complete response in 10% cases. Tumour T category downstaging was seen in 50% of cases. While tumour dimensions/ volume reduced substantially, surgical ease improved in only 40% cases. Conclusion A significant proportion of SGC patients evaluated in our study presented with recurrent and/or advanced disease. NACT caused tumour regression in 90% of cases. However, surgical ease improvement was limited, pointing to a need for surgical modification in such cases. Corneal ulceration was noted in 2 cases with large tumors causing a complete mechanical ptosis. Overall, the study introduced an ease of surgery questionnaire and provided insights into benefits and challenges of using NACT for eyelid SGC management.
{"title":"Neoadjuvant Chemotherapy in Non-Metastatic Eyelid Sebaceous Gland Carcinoma - Report in 10 Cases","authors":"Nipun Kumar, R. Meel, S. Bakhshi, D. Pushpam, N. Pushker, M. Bajaj, S. Kashyap, S. Sen, S. Pathy, Sanjay Sharma","doi":"10.1159/000538295","DOIUrl":"https://doi.org/10.1159/000538295","url":null,"abstract":"Introduction\u0000Eyelid sebaceous gland carcinoma (SGC) is an aggressive malignancy. Surgical excision is the standard treatment for non-metastatic eyelid SGC. This study aimed to evaluate treatment outcomes with use of neoadjuvant chemotherapy (NACT) and any change in ease/difficulty of surgical treatment in such cases. \u0000Methods \u0000This was a prospective interventional study conducted over 24 months period. Histopathologically confirmed cases without any systemic metastasis were included. Clinico-demographic details were collected for 30 patients. 10 patients received NACT using cisplatin and 5-FU. Tumour response was evaluated, using RECIST criteria. An ease of surgery questionnaire was used to assess difficulty of surgical treatment before and after NACT.\u0000Results\u0000Of the 30 patients evaluated for recruitment, 37% had recurrent SGC and 72% had advanced tumour stage. 10 patients were recruited for NACT. There was Partial response in 80% and complete response in 10% cases. Tumour T category downstaging was seen in 50% of cases. While tumour dimensions/ volume reduced substantially, surgical ease improved in only 40% cases. \u0000Conclusion\u0000A significant proportion of SGC patients evaluated in our study presented with recurrent and/or advanced disease. NACT caused tumour regression in 90% of cases. However, surgical ease improvement was limited, pointing to a need for surgical modification in such cases. Corneal ulceration was noted in 2 cases with large tumors causing a complete mechanical ptosis. Overall, the study introduced an ease of surgery questionnaire and provided insights into benefits and challenges of using NACT for eyelid SGC management.","PeriodicalId":506981,"journal":{"name":"Ocular Oncology and Pathology","volume":" 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140222223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
David A. Collet, Julia Canestraro, Ghassan K. Abou-Alfa, David H. Abramson, Eli L. Diamond, J. Francis
Mitogen-activated protein kinase kinase (MEK) inhibitors are targeted anti-cancer agents that are prescribed to treat a broad range of cancers. Despite their strong efficacy profile, MEK inhibitors have been associated with ocular toxicities, most notably, self-limited serous detachments of the neurosensory retina. In this report, we outline three cases of a rarely documented toxicity, MEK inhibitor-associated ocular hypertension.
{"title":"MEK Inhibitor-Associated Ocular Hypertension","authors":"David A. Collet, Julia Canestraro, Ghassan K. Abou-Alfa, David H. Abramson, Eli L. Diamond, J. Francis","doi":"10.1159/000535427","DOIUrl":"https://doi.org/10.1159/000535427","url":null,"abstract":"Mitogen-activated protein kinase kinase (MEK) inhibitors are targeted anti-cancer agents that are prescribed to treat a broad range of cancers. Despite their strong efficacy profile, MEK inhibitors have been associated with ocular toxicities, most notably, self-limited serous detachments of the neurosensory retina. In this report, we outline three cases of a rarely documented toxicity, MEK inhibitor-associated ocular hypertension.","PeriodicalId":506981,"journal":{"name":"Ocular Oncology and Pathology","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139200239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ysé Borella, L. Lumbroso-Le Rouic, Christine Lévy, Sophie Gardrat, Jerzy Klijanienko, Denis Malaise, Rémi Dendale, Nathalie Cassoux, Alexandre Matet
Purpose: Intraocular localization of conjunctival squamous cell carcinoma (SCC) is due to scleral or corneal invasion. Herein we describe the clinical and histopathological findings in four cases of SCC complicated by intraocular invasion, and we review cases reported in the literature and their management. Methods: We retrospectively collected and analyzed clinical characteristics, histopathology, management, and follow-up data from four patients with conjunctival squamous cell carcinoma complicated by intraocular invasion. We reviewed the literature and summarized cases of intraocular invasion by conjunctival SCC reported over the last 30 years. Results: Two patients presented with intraocular invasion by conjunctival SCC at diagnosis. The two others developed intraocular invasion as recurrence of conjunctival SCC, previously treated with excisional biopsy and adjuvant radiotherapy. All four cases had a previous history of conjunctival surgery, but no history of intraocular surgery. Three patients were managed with modified enucleation, including one that required adjuvant orbital radiotherapy. One patient required orbital exenteration. Histopathology analysis showed a well-differentiated conjunctival SCC in all cases. None developed distant localization after at least 2.5-years follow-up. Conclusions: Intraocular invasion is a rare complication of conjunctival SCC. Appropriate treatment in a tertiary center and long-term follow-up are highly recommended.
{"title":"Intraocular invasion by conjunctival squamous cell carcinoma: clinical presentation, histopathological findings and outcome","authors":"Ysé Borella, L. Lumbroso-Le Rouic, Christine Lévy, Sophie Gardrat, Jerzy Klijanienko, Denis Malaise, Rémi Dendale, Nathalie Cassoux, Alexandre Matet","doi":"10.1159/000531983","DOIUrl":"https://doi.org/10.1159/000531983","url":null,"abstract":"Purpose: Intraocular localization of conjunctival squamous cell carcinoma (SCC) is due to scleral or corneal invasion. Herein we describe the clinical and histopathological findings in four cases of SCC complicated by intraocular invasion, and we review cases reported in the literature and their management. Methods: We retrospectively collected and analyzed clinical characteristics, histopathology, management, and follow-up data from four patients with conjunctival squamous cell carcinoma complicated by intraocular invasion. We reviewed the literature and summarized cases of intraocular invasion by conjunctival SCC reported over the last 30 years. Results: Two patients presented with intraocular invasion by conjunctival SCC at diagnosis. The two others developed intraocular invasion as recurrence of conjunctival SCC, previously treated with excisional biopsy and adjuvant radiotherapy. All four cases had a previous history of conjunctival surgery, but no history of intraocular surgery. Three patients were managed with modified enucleation, including one that required adjuvant orbital radiotherapy. One patient required orbital exenteration. Histopathology analysis showed a well-differentiated conjunctival SCC in all cases. None developed distant localization after at least 2.5-years follow-up. Conclusions: Intraocular invasion is a rare complication of conjunctival SCC. Appropriate treatment in a tertiary center and long-term follow-up are highly recommended.","PeriodicalId":506981,"journal":{"name":"Ocular Oncology and Pathology","volume":"48 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139271953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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