RESUMO
Given the fact that infectious agents contribute to around 18% of human cancers worldwide, it would seem prudent to explore their role in neoplasms of the ocular adnexa: primary malignancies of the conjunctiva, lacrimal glands, eyelids, and orbit. By elucidating the mechanisms by which infectious agents contribute to oncogenesis, the management, treatment, and prevention of these neoplasms may one day parallel what is already in place for cancers such as cervical cancer, hepatocellular carcinoma, gastric mucosa-associated lymphoid tissue lymphoma and gastric adenocarcinoma. Antibiotic treatment and vaccines against infectious agents may herald a future with a curtailed role for traditional therapies of surgery, radiation, and chemotherapy. Unlike other malignancies for which large epidemiological studies are available, analyzing ocular adnexal neoplasms is challenging as they are relatively rare. Additionally, putative infectious agents seemingly display an immense geographic variation that has led to much debate regarding the relative importance of one organism versus another. This review discusses the pathogenetic role of several microorganisms in different ocular adnexal malignancies, including human papilloma virus in conjunctival papilloma and squamous cell carcinoma, human immunodeficiency virus in conjunctival squamous carcinoma, Kaposi sarcoma-associated herpes virus or human herpes simplex virus-8 (KSHV/HHV-8) in conjunctival Kaposi sarcoma, Helicobacter pylori (H. pylori,), Chlamydia, and hepatitis C virus in ocular adnexal mucosa-associated lymphoid tissue lymphomas. Unlike cervical cancer where a single infectious agent, human papilloma virus, is found in greater than 99% of lesions, multiple organisms may play a role in the etiology of certain ocular adnexal neoplasms by acting through similar mechanisms of oncogenesis, including chronic antigenic stimulation and the action of infectious oncogenes. However, similar to other human malignancies, ultimately the role of infectious agents in ocular adnexal neoplasms is most likely as a cofactor to genetic and environmental risk factors.
Assuntos
Infecções Oculares Bacterianas/microbiologia , Infecções Oculares Virais/virologia , Neoplasias Oculares/microbiologia , Neoplasias Oculares/virologia , Alphapapillomavirus/isolamento & purificação , Alphapapillomavirus/fisiologia , Carcinoma de Células Escamosas/virologia , Chlamydophila psittaci/isolamento & purificação , Chlamydophila psittaci/fisiologia , Neoplasias da Túnica Conjuntiva/microbiologia , Neoplasias da Túnica Conjuntiva/virologia , Infecções Oculares Bacterianas/patologia , Infecções Oculares Virais/patologia , Neoplasias Palpebrais/microbiologia , Neoplasias Palpebrais/virologia , HIV-1/isolamento & purificação , HIV-1/fisiologia , Helicobacter pylori/isolamento & purificação , Helicobacter pylori/fisiologia , Hepacivirus/isolamento & purificação , Hepacivirus/fisiologia , Herpesvirus Humano 8/isolamento & purificação , Herpesvirus Humano 8/fisiologia , Humanos , Doenças do Aparelho Lacrimal/microbiologia , Doenças do Aparelho Lacrimal/virologia , Linfoma de Zona Marginal Tipo Células B/virologia , Neoplasias Orbitárias/microbiologia , Neoplasias Orbitárias/virologia , Sarcoma de Kaposi/virologiaRESUMO
BACKGROUND: Eyeball destruction caused by invasion of basal cell carcinoma of the eyelid. CASE: A 100-year-old woman showed extensive eyeball destruction caused by the invasion of basal cell carcinoma of the eyelid. Complete ophthalmologic examinations, including computed tomographic (CT) scans of the orbit, were performed. The patient underwent incisional biopsy and bacteriological examination of the exudate from the lesion. OBSERVATIONS: Orbital CT scan showed a mass in the extraconal space of the right orbit, with extension to the adjacent sinus cavity without brain involvement. The remnant of the eyeball was posteriorly displaced. Pseudomonas aeruginosa was identified by culture examination of the exudate. Histological study of the biopsy specimen showed basal cell carcinoma of the noduloulcerative type. CONCLUSIONS: Basal cell carcinoma of the eyelid had caused severe periorbital and eyeball destruction.
