Program Book

1621 EC1
EVALUATION OF THE “HEDGEHOG” SIGNALLING
PATHWAYS (SHH, PTCH-1, GLI-1 LEVELS) IN
SQUAMOUS AND BASAL CELL CARCINOMAS OF THE
YYELIDS AND CONJUNCTIVA
Hayyam Kiratli1, MD, Ali Rıza Cenk Çelebi1, MD, Figen Söylemezoğlu2, MD
(hkiratli@hacettepe.edu.tr)
1. Ocular Oncology Service, Department of Ophthalmology (and Çelebi)
and 2. Department of Pathology, Hacettepe University School of
Medicine, Ankara, Turkey.
Purpose. To assess the role of hedgehog signalling pathways in the
carcinogenesis of eyelid skin and conjunctival epithelial malignant tumors.
Methods. Shh, the major secreted morphogen protein of the pathway,
Ptch-1, its transmembrane receptor and Gli-1, the target gene involved
in stem cell proliferation were evaluated in paraffin-embedded tissues
using immunohistochemical stainings. The study was conducted on the
specimens of 41 patients with eyelid basal cell carcinoma, 22 with eyelid
and conjunctival squamous cell carcinoma and 12 with conjunctival
intraepithelial neoplasia. For each specimen, the percentage (50%) and the intensity of stainings (graded between 0 to 3) were
calculated and the scores obtained by the multiplication of the two values
were analyzed using Kruskall-Wallis test.
Results. The Shh and Ptch-1 expressions were statistically significantly
lower in the basal cell carcinoma group. In the conjunctival squamous cell
carcinoma group, the Ptch-1 score was 0 in 25% of specimens and Gli-1
score was 3 in 66% of cases. In the conjunctival intraepithelial neoplasia
group, the Ptch-1 score was >2 in 66% of specimens and the Gli-1 score
was 3 in 87.5% of cases.
Conclusions. Ptch-1 mutations may contribute to the development of eyelid
basal cell carcinoma. Alterations in the hedgehog signaling pathways may
lead to transformation of the conjunctival intraepithelial neoplasia into
invasive squamous cell carcinoma.
Financial disclosure. None
1246 EC2
MARGIN CONTROL IN EYELID TUMOR EXCISION: IS
FROZEN SECTION OPTIMAL?
David T.L. Liu, Kelvin K.L. Chong, Gary M.K. Tse, N.M. Luk, Dennis S.C.
Lam (david_tlliu@yahoo.com)
Department of Ophthalmology & Visual Sciences, the Chinese University
of Hong Kong; Department of Anatomical & Cellular Pathology, the
Chinese University of Hong Kong; Dermatology Institute, Department of
Medicine & Therapeutics, the Chinese University of Hong Kong
Purpose. To report the surgical outcomes of periocular basal cell
carcinoma (BCC) patients managed with quick Mohs micrographic
surgery (MMS)
Methods. Prospective series of periocular BCC were enrolled and
managed by quick MMS, which is a simple technique of collapsing
thickness of the specimen, single sectioning and one tissue-level
histopathological examination.
Results. Six female and one male, with age ranged from 58 to 88 were
recruited. Median operation time was 30 minutes. Five patients were
free from postoperative complication. At 18 months, no patient showed
sign of recurrence.
EYELID, CONJUNTIVA & ORBIT
Abstracts
67
Conclusions. In the strike for maximal tumor clearance and aesthetic
preservation, Quick Mohs micrographic surgery may be an express
surrogate for the labor-intensive conventional MMS in the management
of periocular BCC.
Financial disclosure. None
1407 EC3
RADIOTHERAPY FOR MANAGEMENT OF MEDIAL
CANTHAL BASAL CELL CARCINOMA (BCC)
Hatem Krema, Caroline Chung, Evelyn Herrmann, Rand Simpson, David
Payne, Normand Laperriere
(htmkrm19@yahoo.com)
Ocular Oncology and Radiation Oncology Department, Princess Margaret
Hospital/ UHN Toronto, Ontario, Canada
Purpose. To report the efficacy and toxicity of fractionated external
beam radiotherapy for management of medial canthal BCC.
Methods. Retrospective case series analysis. We included consecutive
patients with medial canthal BCC treated with orthovoltage radiotherapy
using direct apposition technique. Patients were included whether
radiotherapy was delivered as a primary treatment or for recurrent
cases after surgical excision, between 1998 and 2009. Kaplan-Meier
estimates were used to calculate actuarial rates.
Results. Included in this study were 92 patients with a median follow-up
of 70 months. The median dose was 35 Gys and the median fraction dose
was 7 Gys. The local control rate was 96% for BCCs treated primarily by
radiotherapy, and 78% for recurrent BCCs after prior surgery. There were
transient post radiotherapy complications in 72% of patients. Chronic
epiphora was present in 19% and chronic dry eye symptoms in 15 %.
Conclusions. Radiotherapy provides an alternative management to
surgical excision and major reconstruction procedures for medial
canthal BCC, with manageable post irradiation side effects.
Financial disclosure. None
1756 EC4
DOES THE SIZE OF EYELID SEBACEOUS CARCINOMA
CORRELATE WITH NODAL METASTASIS AND
SURVIVAL?
Bita Esmaeli1, Qasiem Nasser 1, Hilda Cruz1, Melissa Felman1, Carla L.
Warneke4, Doina Ivan2.3 (besmaeli@mdanderson.org)
1. Section of Ophthalmology, Department of Head and Neck Surgery,
2. Department of Pathology,
3. Department of Dermatology,
4. Department of Biostatistics
The University of Texas MD Anderson Cancer Center, Houston, Texas.
Purpose. To evaluate whether the American Joint Committee on Cancer
(AJCC) 7th edition T designation for eyelid carcinomas correlates with
lymph node metastasis, distant metastasis, and survival in patients with
sebaceous carcinoma of eyelid.
Methods. The records of 50 consecutive patients who were treated by
the principal investigator (BE) for a diagnosis of sebaceous carcinoma
of eyelid between May 1999 and August 2010 were reviewed. Each
patient was staged using the AJCC 7th edition TNM (Tumor, Nodal
status, Distant Metastasis) criteria based on clinical, pathologic, and
radiographic data.