RESUMO
BACKGROUND: The main risk factors for squamous cell carcinoma of the conjunctiva (SCCC) are immunodeficiency and exposure to ultraviolet radiation. Little is known about SCCC epidemiology among people with HIV (PWH) in South Africa. METHODS: We used data from the South African HIV Cancer Match study, a nation-wide cohort of PWH in South Africa, created through a privacy-preserving probabilistic record linkage of HIV-related laboratory records from the National Health Laboratory Service and cancer records from the National Cancer Registry from 2004 to 2014. We calculated crude incidence rates, analyzed trends using joinpoint models, and estimated hazard ratios for different risk factors using Royston-Parmar flexible parametric survival models. RESULTS: Among 5â247â968 PWH, 1059 cases of incident SCCC were diagnosed, for a crude overall SCCC incidence rate of 6.8 per 100â000 person-years. The SCCC incidence rate decreased between 2004 and 2014, with an annual percentage change of â10.9% (95% confidence interval: â13.3 to â8.3). PWH residing within latitudes 30°S to 34°S had a 49% lower SCCC risk than those residing at less than 25°S latitude (adjusted hazard ratio = 0.67; 95% confidence interval: 0.55 to 0.82). Other risk factors for SCCC were lower CD4 counts and middle age. There was no evidence for an association of sex or settlement type with SCCC risk. CONCLUSIONS: An increased risk of developing SCCC was associated with lower CD4 counts and residence closer to the equator, indicative of higher ultraviolet radiation exposure. Clinicians and PWH should be educated on known SCCC preventive measures, such as maintaining high CD4 counts and protection from ultraviolet radiation through sunglasses and sunhats when outdoors.
Assuntos
Neoplasias Ósseas , Neoplasias da Mama , Carcinoma de Células Escamosas , Neoplasias da Túnica Conjuntiva , Infecções por HIV , Neoplasias de Cabeça e Pescoço , Pessoa de Meia-Idade , Humanos , Feminino , Incidência , África do Sul/epidemiologia , Raios Ultravioleta/efeitos adversos , Neoplasias da Túnica Conjuntiva/epidemiologia , Neoplasias da Túnica Conjuntiva/complicações , Neoplasias da Túnica Conjuntiva/patologia , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço , Neoplasias da Mama/complicações , Infecções por HIV/complicações , Infecções por HIV/epidemiologiaRESUMO
The purpose of this study is to report a case of bilateral highly locally invasive conjunctival squamous neoplasia in the clinical setting of ocular cicatricial pemphigoid (OCP), and to review the available literature about this rare association.Case description: A man presented with chronic bilateral conjunctivitis and forniceal foreshortening. He had been previously diagnosed with OCP, and received proper therapy with systemic Dapsone and local steroids. After six months from treatment initiation, the patient complained of worsening symptoms and underwent two more biopsies, revealing a bilateral conjunctival squamous neoplasia. Conclusion: In rare cases, OCP can be associated with conjunctival squamous neoplasia. In case of suspected clinical modifications, it is important to make an early diagnosis by repeating several conjunctival biopsies or by performing less invasive diagnostic techniques (e.g. impression cytology of the ocular surface epithelium) to avoid unnecessary surgical damages.
Assuntos
Carcinoma de Células Escamosas , Neoplasias da Túnica Conjuntiva , Conjuntivite , Penfigoide Mucomembranoso Benigno , Masculino , Humanos , Penfigoide Mucomembranoso Benigno/complicações , Penfigoide Mucomembranoso Benigno/diagnóstico , Penfigoide Mucomembranoso Benigno/tratamento farmacológico , Túnica Conjuntiva/patologia , Conjuntivite/diagnóstico , Conjuntivite/tratamento farmacológico , Conjuntivite/etiologia , Neoplasias da Túnica Conjuntiva/complicações , Neoplasias da Túnica Conjuntiva/diagnóstico , Neoplasias da Túnica Conjuntiva/patologia , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patologiaRESUMO
Se presenta un caso atípico de epiteliopatía progresiva en ondas consecutiva a tratamiento tópico de una neoplasia intraepitelial conjuntival en 360°. Se usaron colirios de mitomicina (0,2mg/ml) e interferón (1MUI/ml). Presentación atípica con foco limbar principal migratorio, y no claramente delimitado en su sitio horario a través de su evolución. Tratado con flurometolona y lágrimas artificiales, con resultado de resolución completa (AU)
An atypical Advancing Wavelike Epitheliopathy case, consecutive to topical treatment for a 360° Conjunctival Intraepithelial Neoplasia, is presented. Mitomycin (0.2mg/ml) and interferon (1MUI/ml) drops were used. An atypical presentation, with migrating limbal focus, non clearly delimited in its hourly site through its evolution. Treated with flurometholone drops plus artificial tears, working to complete resolution (AU)
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Carcinoma in Situ/tratamento farmacológico , Neoplasias da Túnica Conjuntiva/tratamento farmacológico , Neoplasias da Túnica Conjuntiva/complicações , Antibióticos Antineoplásicos/administração & dosagem , Interferons/administração & dosagem , Mitomicina/administração & dosagem , Doenças da Córnea/tratamento farmacológico , Administração TópicaRESUMO
Conjunctival tumors result from gain of tissue, which can be either degenerative or neoplastic, but also inflammatory. In this article, degenerative (pterygium and pinguecula) as well as benign and malignant neoplastic conjunctival changes (epithelial, melanocytic and vascular tumors, choristomas as well as metastases) are discussed with regard to pathogenesis, symptoms, diagnostics and current status of treatment.
Assuntos
Neoplasias da Túnica Conjuntiva , Pterígio , Túnica Conjuntiva/patologia , Neoplasias da Túnica Conjuntiva/complicações , Neoplasias da Túnica Conjuntiva/diagnóstico , Neoplasias da Túnica Conjuntiva/terapia , Humanos , Pterígio/diagnóstico , Pterígio/etiologia , Pterígio/patologiaRESUMO
OBJECTIVE: To investigate the association of high-risk hu-man papilloma virus (HR-HPV) and other risk factors with ocular surface squamous cell neoplasia (OSSN). MATERIALS AND METHODS: We obtained DNA from 22 fresh frozen OSSN tissues and 22 pterygia as controls, we used a broad-spectrum HPV DNA amplification short PCR fragment to identify HPV infection in all specimens and then genotyped HPV by a reverse hybridization line probe assay. We also obtained demographic, sun exposure, and tobacco consump-tion information. RESULTS: HR-HPV frequency was 40.9% in the OSSN group and 4.5% in the pterygia group (p=0.009). After covariate adjustment, OSSN was associated with HR-HPV (OR=16.3, 95%CI=1.2,218.1, p=0.03) and sunburn (OR=10.8, 95%CI=1.8,86.0, p=0.02). CONCLUSIONS: Ocular surface squamous cell neoplasia is a multifactorial disease. The strong association between HR-HPV and OSSN, suggests that HR-HPV could play an etiological role in OSSN development.
Assuntos
Alphapapillomavirus , Carcinoma de Células Escamosas , Neoplasias da Túnica Conjuntiva , Neoplasias Oculares , Infecções por Papillomavirus , Carcinoma de Células Escamosas/epidemiologia , Estudos de Casos e Controles , Túnica Conjuntiva/anormalidades , Neoplasias da Túnica Conjuntiva/complicações , Neoplasias da Túnica Conjuntiva/epidemiologia , Neoplasias Oculares/complicações , Neoplasias Oculares/epidemiologia , Humanos , México/epidemiologia , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/epidemiologia , PterígioRESUMO
PURPOSE: To report the unexpected finding of ocular surface neoplasia (OSSN) on conjunctival tissue removed during pterygium surgery and subjected to histopathology analysis. METHODS: This is an observational, descriptive retrospective study in which all the samples removed during surgery between 1997 and 2020 with a clinical diagnosis of pterygium were sent for histopathology analysis in which an unexpected OSSN was found. RESULTS: There were 461 cases with a preoperative diagnosis of pterygium, with a mean age of 30.14 ± 10.6 years. In this group, there was an unexpected finding of OSSN in 69 cases (14.96%) of the surgical samples, with a mean age of 46 ± 8.2 years (31.86 ± 12.13). CONCLUSIONS: The unexpected coincidence of pterygium and OSSN is frequent, although varies depending on the geographical location. We recommend performing a histopathology analysis on every pterygium removed.
Assuntos
Túnica Conjuntiva/patologia , Neoplasias da Túnica Conjuntiva/complicações , Estadiamento de Neoplasias/métodos , Procedimentos Cirúrgicos Oftalmológicos/métodos , Pterígio/cirurgia , Adulto , Biópsia , Colômbia/epidemiologia , Neoplasias da Túnica Conjuntiva/diagnóstico , Neoplasias da Túnica Conjuntiva/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto JovemRESUMO
An elderly white man with a history of left oculodermal melanocytosis presented with new onset brown pigmentation of the left bulbar and inferior tarsal conjunctiva. The bulbar conjunctival pigmentation was at the level of the conjunctival epithelium and was overlying areas of typical slate-grey scleral pigmentation characteristic of oculodermal melanocytosis. Both areas of new pigmentation were biopsied. The bulbar conjunctiva revealed primary acquired melanosis (PAM) without atypia with increased melanin production and the tarsal conjunctival biopsy showed PAM without atypia sine pigmentio overlying areas of substantia propria spindle-shaped heavily pigmented melanocytes of oculodermal melanocytosis. The case report examines the relationship between the epithelial and substantia propria melanocytes and correlates the findings with what is known about this association from the dermatopathology literature.
Assuntos
Neoplasias da Túnica Conjuntiva/patologia , Melanose/patologia , Nevo de Ota/patologia , Neoplasias Cutâneas/patologia , Idoso de 80 Anos ou mais , Túnica Conjuntiva/patologia , Neoplasias da Túnica Conjuntiva/complicações , Humanos , Masculino , Melanócitos/patologia , Melanose/complicações , Nevo de Ota/complicações , Neoplasias Cutâneas/complicaçõesAssuntos
Carcinoma de Células Escamosas/complicações , Neoplasias da Túnica Conjuntiva/complicações , Doença Enxerto-Hospedeiro/complicações , Neoplasias de Cabeça e Pescoço/complicações , Segunda Neoplasia Primária/complicações , Neoplasias Cutâneas/complicações , Evolução Fatal , Neoplasias de Cabeça e Pescoço/patologia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Ceratoconjuntivite Seca/etiologia , Masculino , Pessoa de Meia-Idade , Lesões por Radiação/complicações , Lesões por Radiação/patologia , Neoplasias Cutâneas/patologia , Luz Solar/efeitos adversosRESUMO
PURPOSE: To study the demographic features, treatment, histopathology, and outcomes in patients of xeroderma pigmentosum (XP) with conjunctival melanoma. METHODS: Retrospective case series. RESULTS: The median age at presentation was 18 years (range 9-30 years). There were three females and one male patient presenting with a median duration of symptoms of 3 months (range 1-60 months). The tumor was located in the bulbar conjunctiva in all 4 patients. All patients had corneal involvement by the tumor. The median tumor basal diameter was 7 mm (range 4-15 mm). Wide tumor excisional biopsy with alcohol keratoepithelectomy, cryotherapy to the free margins, and amniotic membrane grafting was done in three patients. One patient underwent orbital exenteration for extensive tumor. One patient also received adjuvant plaque brachytherapy for microscopic residual tumor. Over a median follow-up of 22 months (range 2-101 months), there were no recurrences, metastasis, or death. CONCLUSION: Conjunctival melanoma in XP is rare and manifests at a younger age.
Assuntos
Túnica Conjuntiva/patologia , Neoplasias da Túnica Conjuntiva/complicações , Melanoma/complicações , Xeroderma Pigmentoso/complicações , Adolescente , Adulto , Biópsia , Criança , Neoplasias da Túnica Conjuntiva/diagnóstico , Neoplasias da Túnica Conjuntiva/terapia , Crioterapia/métodos , Feminino , Seguimentos , Humanos , Masculino , Melanoma/diagnóstico , Melanoma/terapia , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento , Xeroderma Pigmentoso/diagnóstico , Xeroderma Pigmentoso/terapia , Adulto JovemAssuntos
Neoplasias da Túnica Conjuntiva/diagnóstico , Neoplasias da Túnica Conjuntiva/patologia , Melanoma/diagnóstico , Melanoma/patologia , Melanose/diagnóstico , Melanose/patologia , Neoplasias da Túnica Conjuntiva/complicações , Feminino , Cabeça/diagnóstico por imagem , Histocitoquímica , Humanos , Melanoma/complicações , Pessoa de Meia-Idade , Recidiva , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVE: To report a case of a patient affected by multiple endocrine neoplasia type 2B (MEN 2B) with imaging of conjunctival neuromas by in vivo confocal microscopy (IVCM). METHODS: Case report. RESULTS: A 48-year-old patient affected by MEN2B complained of progressive visual loss in his right eye and severe red, dry and itchy eyes. Best-corrected visual acuity was 20/63 OD and 20/25 OS. Slit lamp exam showed thickened and turned out lid margins, significant blepharitis, conjunctival injection, multiple presumed subconjunctival neuromas at the bulbar conjunctiva and at the limbus, marked prominence of corneal nerves, exposure keratopathy due to incomplete blinking and corneal hypoesthesia, subepithelial corneal neovascularization and scarring in the mid inferior part of both corneas and bilateral iris nodules. We performed IVCM on conjunctival neuromas, revealing large, thick bundles of nerves with disorganization, prominent loops, bifurcations and dilations measuring as much as 1 mm. The IVCM of corneal nerves demonstrated hypertrophic sub basal plexus. CONCLUSIONS: To date, this is the first report which documents conjunctival neuromas by confocal microscopy in MEN2B.
Assuntos
Túnica Conjuntiva/inervação , Neoplasias da Túnica Conjuntiva/diagnóstico , Córnea/inervação , Doenças da Córnea/diagnóstico , Microscopia Confocal/métodos , Neoplasia Endócrina Múltipla Tipo 2b/complicações , Nervo Oftálmico/patologia , Túnica Conjuntiva/patologia , Neoplasias da Túnica Conjuntiva/complicações , Córnea/patologia , Doenças da Córnea/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Lâmpada de Fenda , Acuidade VisualRESUMO
Xeroderma pigmentosum (XP) is an autosomal recessive disease with ophthalmic, dermatologic, and neurologic manifestations. Ophthalmological changes are described in up to 100% of XP patients. We report a young XP patient that presented with bilateral conjunctival masses. She was treated by surgical excision with supplemental cryotherapy. The histopathological analysis revealed squamous cell carcinoma with melanosis on right eye and conjunctival melanoma on the left eye. These patients need to be followed by dermatologists and ophthalmologists to identify malignant lesions as soon as possible and also to prevent unnecessary surgery that increases mutilation.
Assuntos
Carcinoma de Células Escamosas/diagnóstico , Túnica Conjuntiva/patologia , Neoplasias da Túnica Conjuntiva/diagnóstico , Melanoma/diagnóstico , Neoplasias Primárias Múltiplas , Xeroderma Pigmentoso/complicações , Adolescente , Biópsia , Neoplasias da Túnica Conjuntiva/complicações , Feminino , Humanos , Melanoma/complicações , Estadiamento de NeoplasiasRESUMO
PURPOSE: To describe a rare co-occurrence of ocular surface squamous neoplasia (OSSN) in a patient with microbial keratitis. METHODS: Case report. RESULTS: We describe a 68-years female who developed ocular surface squamous neoplasia (OSSN) in an eye with culture proven severe fungal keratitis of 5 months duration, which progressed to endophthalmitis. She was managed with extended enucleation for left eye. Histopathology examination was consistent with squamous cell carcinoma of ocular surface with no corneal stromal/scleral/anterior chamber involvement. She received adjuvant chemotherapy with topical Interferon alpha2b (3 cycles) for positive margins. Six months after treatment, she is completely tumor free. CONCLUSION: Co-occurrence of OSSN and chronic fungal keratitis is rare. We recommend that patients with chronic ocular infections should be examined and followed closely for abnormally thickened limbal areas.
Assuntos
Carcinoma de Células Escamosas/complicações , Neoplasias da Túnica Conjuntiva/complicações , Infecções Oculares Fúngicas/complicações , Ceratite/complicações , Idoso , Antifúngicos/uso terapêutico , Curativos Biológicos , Biópsia , Carcinoma de Células Escamosas/diagnóstico , Neoplasias da Túnica Conjuntiva/diagnóstico , Neoplasias da Túnica Conjuntiva/cirurgia , Infecções Oculares Fúngicas/diagnóstico , Infecções Oculares Fúngicas/tratamento farmacológico , Infecções Oculares Fúngicas/cirurgia , Feminino , Humanos , Ceratite/diagnóstico , Ceratite/tratamento farmacológico , Fotocoagulação a LaserAssuntos
Neoplasias da Túnica Conjuntiva/complicações , Transplante de Córnea/efeitos adversos , Neoplasias Cutâneas/complicações , Carcinoma de Células Escamosas de Cabeça e Pescoço/complicações , Xeroderma Pigmentoso/complicações , Feminino , Humanos , Lipídeos/química , Neovascularização Patológica , Cicatrização , Adulto JovemRESUMO
Sympathetic ophthalmia (SO) is a rare, diffuse, bilateral, and granulomatous nonnecrotizing panuveitis that may follow intraocular penetrating trauma. Our aim is to report a rare case of SO following orbital exenteration. Orbital exenteration was performed on a 48-year-old african female due to conjunctival keratinizing squamous cell carcinoma with intraocular involvement of the left eye. Five days after the uneventful procedure, the patient presented signs and symptoms compatible with SO. Key differential diagnoses were excluded, and prompt and aggressive immunosuppression was started with a favourable but slow clinical response. This case highlights the fact that SO can also be induced by a neoplasm with intraocular invasion or by aggressive nonpenetrating surgery. While the underlying pathogenesis of SO is still not fully elucidated, we hereby contribute with a novel potential mechanism leading to its development.
Assuntos
Carcinoma de Células Escamosas/complicações , Neoplasias da Túnica Conjuntiva/complicações , Oftalmia Simpática/etiologia , Carcinoma de Células Escamosas/diagnóstico , Neoplasias da Túnica Conjuntiva/diagnóstico , Diagnóstico Diferencial , Feminino , Angiofluoresceinografia , Fundo de Olho , Humanos , Pessoa de Meia-Idade , Oftalmia Simpática/diagnóstico , Órbita/patologia , Tomografia de Coerência ÓpticaRESUMO
Squamous cell carcinoma arising from conjunctiva in the anophthalmic socket decades following enucleation is rare, but has been previously described. The authors report the first case associated with human papillomavirus (serotype 16) with regional metastases. The patient ultimately underwent orbital exenteration along with parotidectomy and neck dissection which revealed positive lymph nodes. The literature is reviewed relating to this uncommon entity and its management with an analysis of potential contributing risk factors.
Assuntos
Anoftalmia/complicações , Anticorpos Antivirais/imunologia , Carcinoma de Células Escamosas/diagnóstico , Túnica Conjuntiva/patologia , Neoplasias da Túnica Conjuntiva/diagnóstico , Papillomavirus Humano 16/imunologia , Infecções por Papillomavirus/diagnóstico , Carcinoma de Células Escamosas/complicações , Neoplasias da Túnica Conjuntiva/complicações , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Infecções por Papillomavirus/complicações , Tomografia Computadorizada por Raios XAssuntos
Carcinoma de Células Escamosas/diagnóstico por imagem , Neoplasias da Túnica Conjuntiva/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Neoplasias Primárias Múltiplas/diagnóstico por imagem , Neoplasias Orbitárias/diagnóstico por imagem , Síndrome da Imunodeficiência Adquirida/complicações , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/patologia , Neoplasias da Túnica Conjuntiva/complicações , Neoplasias da Túnica Conjuntiva/patologia , Neoplasias de Cabeça e Pescoço/complicações , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Neoplasias Primárias Múltiplas/complicações , Neoplasias Primárias Múltiplas/patologia , Neoplasias Orbitárias/complicações , Neoplasias Orbitárias/patologia , Índice de Gravidade de Doença , Carcinoma de Células Escamosas de Cabeça e Pescoço , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: Interferon α2b (IFN α2b) is an established and well-tolerated treatment for ocular surface squamous neoplasia (OSSN). METHOD: Report of complications in two patients with OSSN and rheumatoid arthritis treated with adjuvant topical IFN α2b. RESULTS: One patient developed a scleral melt and the other one severe keratitis. After discontinuing treatment with IFN α2b both patients showed considerable improvement. CONCLUSION: Immunosuppressed patients with OSSN under topical IFN α2b should be closely monitored for early detection of complications.
Assuntos
Artrite Reumatoide/complicações , Carcinoma de Células Escamosas/tratamento farmacológico , Neoplasias da Túnica Conjuntiva/tratamento farmacológico , Interferon-alfa/efeitos adversos , Interferon-alfa/uso terapêutico , Ceratite/induzido quimicamente , Doenças da Esclera/induzido quimicamente , Idoso , Carcinoma de Células Escamosas/complicações , Neoplasias da Túnica Conjuntiva/complicações , Feminino , Humanos , Interferon alfa-2 , Ceratite/patologia , Ceratite/prevenção & controle , Pessoa de Meia-Idade , Proteínas Recombinantes/efeitos adversos , Proteínas Recombinantes/uso terapêutico , Recurvamento da Esclera , Doenças da Esclera/patologia , Doenças da Esclera/prevenção & controle , Resultado do TratamentoRESUMO
CASE REPORT: A 43-year-old woman presented with a salmon-coloured patch of 0.7mm diameter in the right eye that extended into the lower fornix in the bulbar and tarsal conjunctiva, with irregular edges, and highly vascularised. Incisional biopsy was performed, showing it to be a low-grade conjunctival non-Hodgkin B cell lymphoma (or a mucosa associated lymphoid tissue [MALT] lymphoma). DISCUSSION: The lesion remained stable for 24 months of follow-up, when a relapse of the condition occurred, producing an enlargement of the initial lesion. The definitive diagnosis is made by biopsy of the affected tissue and histopathologic study.