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INTRODUCTION: The prevalence of squamous cell carcinoma of the eyeball is low, and this is a rare condition. There are multiple therapeutic strategies for the treatment and depend on the degree of local involvement and extension of the tumor which, in turn, will have an impact on the patient's prognosis. PRESENTATION OF CASE: We present a case of a patient with a mass of progressive growth on the left eyeball whit vision damage. The biopsy showed a squamous cell carcinoma of the conjunctiva, and imaging studies showed orbital invasion cT4bN0cM0, so surgery was indicated. The surgery was done with macroscopic margins of 5 mm. After resection, a radial free flap reconstruction was performed. Adjuvant treatment with radiotherapy was performed without complications. After six months, the patient manifested an improvement in his quality of life, and there is no evidence of relapse. DISCUSSION: The prevalence of squamous cell carcinoma of the conjunctiva is low. The most important risk factor is exposure to UV rays. Most are derived from conjunctival intraepithelial neoplasms. There are topical management protocols with chemotherapeutic agents and in patients with ocular or orbital invasion, enucleation and exanteration are the treatments of choice. CONCLUSION: The squamous cell carcinoma of the conjunctive is rare. The management in the locally advanced tumors is surgical. The use of a radial free flap reconstruction is one of the reconstructive strategies to take into account, and the knowledge of additional strategies required to control the disease is important to ensure an optimal treatment.
RESUMEN
Introducción: en el campo de la salud, cada decisión representa datos, y las técnicas de minería de datos han empezado a ser una metodología prometedora para el análisis de esta información, especialmente en el diseño de los modelos predictivos. Métodos: estudio observacional analítico de pacientes mayores de 15 años, con reporte de punción de aspiración con aguja fina con estudio Bethesda IV, sometidos a manejo quirúrgico en el Hospital de San José de Bogotá. Los datos recogidos de los pacientes se incluyeron en tres grupos: la información sociodemográfica y clínica, los hallazgos en la citología y los reportes de la ecografía. Se realizó el análisis mediante Naive-Bayes, árbol de decisión y redes neuronales. Se usó la herramienta Weka versión 3.8.2. Resultados: de los 427 pacientes, 195 tuvieron resultados de patología de carcinoma de tiroides (45,6 %). Se evidenciaron mejores resultados usando la validación cruzada (10 fold) comparado con partición (66 %), la técnica de Bayes tuvo mejores resultados de clasificación correcta (91,1 %), comparado con la técnica de árbol (87,8 %) y la red neuronal (88,2 %). Conclusiones: el uso de la técnica de Naive Bayes muestra una importante exactitud para determinar la predicción de riesgo de malignidad en los pacientes con estudio citológico Bethesda IV, lo cual permitiría orientar de forma adecuada el manejo quirúrgico de los pacientes
Introduction: In the health field, each decision represents data, and data mining techniques have begun to be a promising methodology for the analysis of this information, especially in the design of predictive models. Methods: Analytical observational study; patients older than 15 years with a report of Bethesda IV after a fine needle aspiration biopsy that undergoing surgical management at the Hospital de San José in Bogotá. The data collected from those patients were included in three groups: sociodemographic-clinical information, cytology findings, and ultrasound reports. Analysis was performed using three technics: Naive Bayes, decision trees, and neural networks. Weka tool version 3.8.2 was used. Results: 195 patients out of 427, had a thyroid carcinoma pathology (45.6%). Better results were evidenced using cross-validation (10 fold) compared with a partition (66%), the Bayes technique had better results of correct classification (91.1%), than the tree technique (87.8%) and neural network (88.2%). Conclusions: The use of the Naive Bayes technique shows an important accuracy to determine the prediction of risk of malignancy in patients with a Bethesda IV cytological study, which would allow an adequate guide to the surgical management of patients.