RESUMEN
PURPOSE: To describe the clinical features, histopathology, treatment, and outcomes of patients with ocular surface squamous neoplasia (OSSN) presenting to a referral centre in India. METHODS: Retrospective interventional study. RESULTS: Of 438 patients, the mean age at presentation was 49 years. Human immunodeficiency virus infection was noted in 72 (16%), xeroderma pigmentosum in 22 (5%), hepatitis B virus infection in 14 (3%), and systemic cancer in 8 (2%) patients. Tumor pigmentation was noted in 243 (54%) tumors with a mean percentage of tumor pigmentation of 44% (median, 40%; range, 1 to 100%). Intraocular tumor extension was noted in 12 (3%), and orbital tumor extension in 16 (4%) eyes. Of the 381 treated lesions, excisional biopsy (n = 247; 65%) was the most common treatment modality. Of the 311 lesions with histopathology diagnosis of OSSN, invasive squamous cell carcinoma (n = 92; 30%) was the most common. Over a mean follow-up period of 11 months (median, 5 months; range, 1 to 108 months) in 368 patients, tumor recurrence was noted in 16 (4%) eyes, globe salvage was achieved in 341 (90%) eyes, vision salvage in 338 (89%) eyes, regional lymph node metastasis occurred in 9 (2%), and metastasis-related death in 9 (2%) patients. CONCLUSION: Pigmented OSSN is common in Asian Indian population. Appropriate management of OSSN is associated with good vision, globe, and life salvage rates in India.
Asunto(s)
Carcinoma de Células Escamosas , Neoplasias de la Conjuntiva , Neoplasias del Ojo , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/epidemiología , Carcinoma de Células Escamosas/terapia , Neoplasias de la Conjuntiva/diagnóstico , Neoplasias de la Conjuntiva/epidemiología , Neoplasias de la Conjuntiva/terapia , Neoplasias del Ojo/diagnóstico , Neoplasias del Ojo/epidemiología , Neoplasias del Ojo/terapia , Humanos , India/epidemiología , Recurrencia Local de Neoplasia , Estudios RetrospectivosRESUMEN
PURPOSE: To report the phenomenon of spontaneous regression in presumed ocular surface squamous neoplasia (OSSN). METHODS: Retrospective chart review of clinically diagnosed cases of OSSN during 2016 to 2019. RESULTS: Of the 449 OSSN lesions, spontaneous regression was seen in 8 lesions (2%). The mean age at diagnosis of OSSN was 37 years (median, 36 years; range, 21 to 59 years). All were males with unilateral, treatment-naïve tumors. Mean duration of symptoms was 3 months (median, 2 months; range, 1 to 12 months). All tumors arose within the interpalpebral region, located in the nasal quadrant in 88% (n = 7) and in temporal quadrant in 12% (n = 1). The mean tumor diameter was 4 mm (median, 4 mm; range, 3 to 5 mm). Lesions showed nodular (n = 4; 50%) or placoid (n = 4; 50%) morphology. The other features included keratin production and intrinsic vascularity (n = 8; 100%), feeder vessels (n = 4; 50%), and intratumoral pigmentation (n = 4; 50%). The diagnosis of OSSN was confirmed by classic anterior segment optical coherence tomography (AS-OCT) features. Tumors regressed after a mean period of 5 months (median, 4 months; range, <1 to 17 months) from presumed onset and a mean period of 2 months (median, 1 month; range, <1 to 6 months) from presentation to the clinic. No recurrences were noted at a mean follow up of 37 months (median, 35 months; range, 17 to 52 months) after spontaneous regression of tumors. CONCLUSION: OSSN can spontaneously regress in 2% of cases. Immune-mediated reversal of dysplastic changes may explain this phenomenon. PRÉCIS: In this study, spontaneous regression of presumed ocular surface squamous neoplasia was noted in 2% patients. Tumor regression resulted in restoration of normal epithelial architecture and no recurrences were observed during the follow-up period.
