Table of Contents - WOC 2012

FP-ONC-SA 172 (3)
Conjunctival Squamous Cell Carcinoma Arising in
Immunosuppressed Patients with HIV or Following Organ
Transplantation
Shields Carol L. (1) , Ramasubramanian Aparna (1) , Mellen Phoebe L. (1) ,
Shields Jerry A. (1)
1. Wills Eye Institute
Purpose: To describe the relationship between chronic systemic immune
suppression and conjunctival squamous cell carcinoma (SCC). Methods:
Chart review of 13 patients.
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. Three patients showed aggressive recurrence
and one patient died from brain invasion. 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. One patient showed aggressive extensive
recurrence and there were no deaths. Of the 5 patients treated with excision
and prompt topical interferon alpha 2B, none showed recurrence.
Conclusions: Conjunctival SCC can occur in immune suppressed patients and
can be more aggressive. Early detection of malignancy with complete
eradication is advised. Topical interferon alpha 2B might reduce risk for
recurrence/new tumor.
FP-ONC-SA 172 (4)
Periocular Basal Cell Carcinoma: Tumor Recurrence After Resection
under Frozen Section Control
Chaudhry Imtiaz (1) , Al-Marwani Maher (2) , Al-Ali Naif (2) , Al-Sheikh Osama (1) ,
Al-Rashed Waleed (3)
1. Oculoplastic and Orbit Division, King Khaled Eye Specialist Hospital
2. Ophthalmology Residency, King Khaled Eye Specialist Hospital, King Saud
University
3. College of Medicine, Imam Muhammad Ibn Saud University
Purpose: To present recurrence of periocular basal cell carcinoma after
excision under Frozen section control in patients presenting to a tertiary care
center in the Middle East.
Methods: Clinical records of patients with periocular basal cell carcinomas
presenting to King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia, were
studied for the recurrence of the tumor after having complete excision under
frozen section control over a 10-year period.
Results: Among the 133 patients (78 male, 55 female; average age 66.2 years,
range 12-104 years), 105 required excision of their basal cell carcinoma under
frozen section control. Among these, 17 (16.2%) had recurrence of their basal
cell carcinoma during the study period. Recurrence of tumor was more likely in
cases of medial canthal involvement, previous incomplete excisions, delayed
presentation or referral and lack of closer observation.
Conclusion: Despite histopathological evidence of free tumor margins during
excision of periocular basal cell carcinoma under frozen section control,
significant number of patients may develop recurrence of the tumor. Closer
observation may be essential in patients with high risk tumors in the
management of periocular basal cell carcinomas.
WOC2012 Abstract Book
FP-ONC-SA 172 (5)
Experience of Outcome and Recurrence of Ocular Surface
Squamous Cell Neoplasia After Excision Followed by 0.04mg/ml
Mitomycin C Topical Preparation
Kamal Sidiqui Zahid (1) , Farooq M. Umer (2) , Karamat M. Irfan (1) , Aftab Muhammad
(1)
1. Post-Graduate Medical Institute
2. Lahore General Hospital
Purpose: To study the clinical presentation and the management outcome of
ocular surface squamous neoplasia (OSSN) using excision followed by topical
mitomycin C (0.04mg/ml).
Methods: This is a prospective descriptive study of patients with conjunctival
mass. The patient underwent excision of the lesion, with 3mm clear margin and
cryotherapy or light coagulation with diathermy of the ocular surface. It was
followed by 4 cycles of 0.04mg/ml mitomycin C topical preparation. Follow-up
of six months was done.
Results: 16 patients were included. Twelve patients (75%) were male and 4
(25%) female. The age range was 14-78 years (mean 47.25). 10 (62.5%)
patients underwent excision of lesion + diathermy, 4 (25%) patients underwent
excision + cryotherapy, 1 (6.25) patient underwent excision only, 1 (6.25)
patient underwent incisional biopsy only. All patients were given post-op
Mitomycin C. There was recurrence in 2 patients who underwent excision +
cryotherapy with post-op mitomycin C. They were managed with re-excision +
diatheramy. There was no recurrence in rest of the patients.
Conclusions: Excision of conjunctival mass + diathermy, followed by post-op 4
cycles of mitomycin C topical drops carries a very favourable prognosis.
FP-ONC-SA 172 (6)
Efficacy of Interferon Alpha-2b in the Management of Ocular Surface
Squamous Neoplasia: Based on American Joint Committee on
Cancer (AJCC) Classification
Kaliki Swathi (1) , Shields Carol (1) , Al Dahmash Saad (1) , Shah Sanket (1) , Lally
Sara (1)
1. Wills Eye Institute
Purpose: To assess efficacy of topical and injection interferon alpha-2b
(IFNα2b) in the management of ocular surface squamous neoplasia (OSSN).
Methods: Retrospective study of 83 cases Results: Based on AJCC
classification, the OSSN was classified as Tis (n=10, 12%), T1 (n=13, 16%), T2
(n=6, 7%), T3 (n=53, 64%), or T4 (n=1,1%). IFN was used for immunotherapy
alone without additional therapy (n=23) or immuno-reduction before surgical
excision (n=7) or immuno-prevention after surgical excision for prevention of
recurrence (n=53). Of the 23 cases of immunotherapy, IFNα2b alone offered
complete control in 75% (3/4) Tis, 100% (8/8) T1, 82% (9/11) T3, after 11
months of mean treatment period. Of the 7 cases of immuno-reduction, 20%
tumor reduction was achieved in T2 (n=1) after 9 months of IFNα2b, and 43%
mean tumor reduction in T3 (n=6) after mean treatment period of 5 months. Of
the 83 cases, tumor recurrence was noted in 4 cases (5%) including 1 Tis, 1
T1, and 2 T3 tumors over median follow-up of 12 months. Minimal side effects
were noted in 16 (21%) patients.
Conclusion: Interferon a2b can be used as sole immunotherapy for smaller
OSSN (Tis, T1), and as immuno-reduction/immuno-prevention for larger (T2,
T3, and T4) tumors.
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