Program Book

1849 ECp101
FIVE CASES OF CARCINOMA METASTASIC TO THE
EYELIDS
Hiroya Kashiwagi1, Hirohisa Katagiri2, Takuya Takagi2, Hideki Murata2,
Mitsuru Takahashi2, Toshiaki Takahashi3 , Masato Matsuzaki4
(h.kashiwagi@scchr.jp)
1. Ophthalmology, 2. Orthopedics, 3. Thoracic Oncology, and 4. Urology,
of Shizuoka Cancer Center
Purpose. We report 5 rare cases of carcinoma metastasis to the eyelid.
Methods. We reviewed the medical records of 5 patients with metastatic
eyelid carcinoma who consulted the Shizuoka Cancer Center from April
2007 to March 2011.
Results. Four of the patients were male and one was female (age range,
42–71 years; average age, 62.4 years). The primary tumors were a seminal
vesicle leiomyosarcoma, an occult primary neuroendocrine carcinoma, a
lung cancer, occult primary sarcoma, and a renal cell carcinoma. The site of
carcinoma was the upper eyelid in 3 cases and the lower in 2 cases. The renal
cell carcinoma was the only tumor that was discovered before the primary
lesion was found. The treatment given was complete removal in 1 case,
excisional biopsy in 1case, and incisional biopsy in 3 cases. Three patients
died of systemic metastatic disease, and the time to death from discovery of
the lesion was 2–3 months (average, 2.3 months). The leiomyosarcoma was
resistant to chemotherapy and irradiation. The occult primary sarcoma was
treated with macroscopic complete extraction. Therefore, chemotherapy
was administered, and it was found to be effective with no recurrence. The
renal cell carcinoma showed rapid growth even after the primary carcinoma
was removed completely; therefore, complete resection with a safety margin
of 5 mm was performed, and no recurrence has been reported to date.
Conclusions. We think that early extraction are necessary for sarcoma.
Oncologists should also understand that eyelid lesions may progress even
if the primary tumor was removed.
Financial disclosure. None
1516 ECp102
NATURAL KILLER/T-CELL LYMPHOMAS IN OCULAR
LESION
Hideki Tsuji, Megumi Kobayashi, Kengo Takeuchi, Kazuhiro Oshitari,
Keigo Shikishima (tsuji-tky@umin.ac.jp)
The Cancer Institute Hosptal
Purpose. The importance of malignant lymphomas (ML) in ocular
oncology is widely known. However, NK/T ML constitute a extremely
small fraction of ocular adnexal lymphomas (OAL). We show the cases
of NK/T in OAL.
Methods. Case reports of NK/T malignant lymphomas (ML) of medial
rectus muscle (68y.o.M) and of eyelid (60 y.o. F).
Results. Both cases had aggressive clinical coarse even with radiation
and chemotherapy, especially the medial rectus muscle case recurred
and showed poor prognosis.
Conclusions. NK/T ML in OAL have different clinical course compared with
MALT lymphoma. These cases suggest us about clinical and pathological
varieties of OAL and each subtype ML requires each prompt therapeutic strategies.
Financial disclosure. None
2337 ECp103
CONJUNCTIVAL SQUAMOUS CELL CARCINOMA
EYELID, CONJUNTIVA & ORBIT
Abstract Posters
83
ARISING IN IMMUNOSUPPRESSED PATIENTS (ORGAN
TRANSPLANT, HUMAN IMMUNODEFICIENCY VIRUS
INFECTION)
Carol L. Shields, M.D., Aparna Ramasubramanian, M.D., Phoebe L. Mellen,
B.S., Jerry A. Shields, M.D. (carol.shields@shieldsoncology.com)
Wills Eye Institute
Purpose. To describe the relationship between chronic systemic immune
suppression and conjunctival squamous cell carcinoma (SCC).
Methods. Surgical excision in all cases plus additional topical interferon
alpha 2B and/or mitomycin
Results. There were three groups of patients with chronic
immunosuppression and conjunctival SCC, including post organ
transplant (n=8), human immunodeficiency virus (HIV) (n=4), and
systemic lupus erythematosis (SLE) on long-term corticosteroids (n=1).
The transplanted organ was kidney (n=4), lung (n=2), liver (n=1),
and heart (n=1). The mean patient age at presentation for the organ
transplant group was 60 years and the mean interval from transplant
to conjunctival SCC was 8.2 years. Management included surgical
excision (n=8) plus additional topical interferon alpha 2B (n=3) and
mitomycin C (n=1). Three patients showed aggressive recurrence. In
the HIV group, the mean patient age at presentation was 54 years and
the mean interval from HIV diagnosis to conjunctival SCC was 5 years.
Management included surgical excision (n=5) plus additional topical
interferon alpha 2B (n=3) and mitomycin C (n=1). One patient showed
aggressive extensive recurrence. Of the 5 patients treated with excision
and prompt topical interferon alpha 2B, none showed recurrence or new
tumor.
Conclusions. Conjunctival SCC can occur in immune suppressed patients
and can be more aggressive and invasive, requiring enucleation or
exenteration. Surgical resection plus topical interferon alpha 2B might
reduce the risk for recurrence/new tumor.
Financial disclosure. None
1822 ECp104
SQUAMOUS NEOPLASIA OF THE OCULAR SURFACE
INVADING THE EYE AND ORBIT: A STUDY OF 30 CASES
Eduardo F. Marback, Ediney Vila Nova Silva, Roberto L. Marback
(eduardomarback@uol.com.br)
Federal University of Bahia - Brazil
Purpose. To evaluate cases of squamous neoplasia of the ocular surface
(SNOS) with orbital or intraocular invasion that required mutilating
surgery.
Methods. A review in the registry book from the Ophthalmic Pathology
Laboratory at Federal University of Bahia – Brazil from January 2000 to
December 2009 was conducted looking for entries with histopathologic
diagnosis of SNOS. Cases with intraocular or orbital invasion that
required mutilating surgery (eye enucleation or orbital exenteration)
were selected. Collected data included age, sex, preoperative visual
acuity, duration of symptoms and presence of previous surgery.
Results. From 213 cases of SNOS, 30 (14%) had conjunctival squamous
cell carcinoma that necessitated mutilating surgery. Thirteen (43%)
patients required eye enucleation and 17 (57%) required orbital
exenteration. In the enucleation group the mean age at diagnosis was
62,9 years-old (ranging from 42 to 95), 10 (77%) patients were male,
the mean duration of symptoms was 15,2 months (ranging from 3 to