1
|
Mandava A, Koppula V, Reddy AK, Ali AZ, Mallavarapu KM. Imaging in Ocular Surface Squamous Cell Carcinoma: There's More to PET/CT Than Meets the Eye. Clin Nucl Med 2024; 49:e403-e405. [PMID: 38861368 DOI: 10.1097/rlu.0000000000005292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
ABSTRACT A 56-year-old woman presenting with swelling, redness, and pain in the left eye, initially treated with topical therapy for conjunctival squamous neoplasia, developed visual loss with progression of swelling in the left eye over the next year. Patient was referred for imaging as she also had significant weight loss and palpable neck swellings. Whole-body 18 F-FDG PET/CT revealed hypermetabolic left eye lesion; metastases in bilateral submandibular glands; cervical, mediastinal, and axillary lymph nodes; and a right lung nodule. Patient was diagnosed with ocular surface squamous cell carcinoma with metastases and started on systemic chemotherapy (cisplatin, paclitaxel, and 5-fluorouracil).
Collapse
Affiliation(s)
| | | | | | | | - Krishna Mohan Mallavarapu
- Medical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| |
Collapse
|
2
|
Esmaeli B, Fan J, Goldberg H, Lu T, Gross ND, Akhave N, Sousa LG, Ferrarotto R. Immune checkpoint inhibitors with or without chemotherapy for orbital, conjunctival, and ocular adnexal squamous cell carcinoma. CANADIAN JOURNAL OF OPHTHALMOLOGY 2024:S0008-4182(24)00166-2. [PMID: 39043259 DOI: 10.1016/j.jcjo.2024.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 04/28/2024] [Accepted: 05/20/2024] [Indexed: 07/25/2024]
Abstract
OBJECTIVE Periocular squamous cell carcinoma (SCC) is relatively rare and presents unique anatomic considerations due to proximity to the eye and risk to ocular structures associated with high-dose radiation therapy or radical surgery. We present our observations in patients with periocular SCC treated with immune checkpoint inhibitor (ICI) therapy in an effort to decrease surgical morbidity or avoid high-dose radiation therapy. METHODS Retrospective review of patients with orbital, conjunctival, or periocular SCC who were treated with ICI either in the neoadjuvant setting prior to surgery or for treatment of perineural spread in the orbit/skull base. RESULTS Twelve men and 5 women with orbital (n = 6), conjunctival (n = 5), or lacrimal sac/duct (n = 2) SCC, or SCC with perineural spread (n = 4) were treated with ICI (cemiplimab or pembolizumab) either as single drug (n = 9) or combined with chemotherapy (n = 8). Overall, 5 patients achieved complete response, 8 patients achieved partial response, and 4 patients achieved stable disease, using the response evaluation criteria in solid tumors (RECIST) criteria. The objective response rate was 76.5%. In 12 patients ICI was used in the neoadjuvant setting prior to surgery. In 4 patients with perineural spread and unresectable disease, ICI was used to avoid high-dose radiation therapy. One additional patient with conjunctival SCC with nodal metastasis was treated with ICI alone and achieved a dramatic complete response and has thus far managed to avoid surgery altogether. CONCLUSIONS ICI either as single drug or in combination with chemotherapy has a high response rate in patients with periocular SCC. Future prospective trials should aim to correlate molecular data with response.
Collapse
Affiliation(s)
- Bita Esmaeli
- Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX.
| | - Janet Fan
- Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Hila Goldberg
- Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Tracy Lu
- Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Neil D Gross
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Neal Akhave
- Department of Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Luana Guimaraes Sousa
- Department of Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Renata Ferrarotto
- Department of Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| |
Collapse
|
3
|
Chebib E, Rougier G, Dubray-Vautrin A, Martin J, Ghanem W, Lesnik M, Sabran B, Matet A, Malaise D, Cassoux N, Dendale R, Choussy O, Badois N. Lymph Node Evolution in Eyelid and Orbit Squamous Cell Carcinomas. Laryngoscope 2024. [PMID: 39031611 DOI: 10.1002/lary.31584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 04/04/2024] [Accepted: 05/22/2024] [Indexed: 07/22/2024]
Abstract
OBJECTIVES To describe a large cohort of eyelid and periorbital SCCs, to compare the location of the tumor and of the pathological lymph nodes, and to analyze the risk factors for lymph node involvement among tumor characteristics. METHODS All patients managed inside our institution for an eyelid and periorbital SCCs were included. Tumor characteristics, imaging setup, excision margins, lymph node evolution features, local, regional, and distant recurrences rates, and global survival were reported. The risk for lymph node involvement and location of pathological lymph nodes were analyzed through univariate and multivariate analyses. RESULTS Between January 2012 and August 2022, 115 patients were included, and 18 presented a lymph node evolution (15.7%), involving the parotid gland in 16 cases (88.9%), the submental and submandibular areas in seven cases (38%), and the jugular and carotid areas in four cases (22%). Tumor size above 20 mm, infiltration of the external canthus and periorbital structures, the presence of perineural invasion or vascular embolism, the depth of infiltration, and the presence of a local recurrence were significantly associated with the risk of lymph node evolution. CONCLUSION Periorbital and eyelid SCCs present a true potential for lymph node evolution especially through the parotid gland. Extension setup including the parotid gland and neck should be mandatory, and lymph node dissection should be associated in case of parotidectomy for lymph node involvement. LEVEL OF EVIDENCE IV Laryngoscope, 2024.
Collapse
Affiliation(s)
- Emilien Chebib
- Head & Neck Oncologic and Reconstructive Surgery Department, Institut Curie, Ear, Nose & Throat, Paris, France
| | - Guillaume Rougier
- Head & Neck Oncologic and Reconstructive Surgery Department, Institut Curie, Ear, Nose & Throat, Paris, France
| | - Antoine Dubray-Vautrin
- Head & Neck Oncologic and Reconstructive Surgery Department, Institut Curie, Ear, Nose & Throat, Paris, France
| | - Joey Martin
- Head & Neck Oncologic and Reconstructive Surgery Department, Institut Curie, Ear, Nose & Throat, Paris, France
| | - Wahib Ghanem
- Head & Neck Oncologic and Reconstructive Surgery Department, Institut Curie, Ear, Nose & Throat, Paris, France
| | - Maria Lesnik
- Head & Neck Oncologic and Reconstructive Surgery Department, Institut Curie, Ear, Nose & Throat, Paris, France
| | - Baptiste Sabran
- Head & Neck Oncologic and Reconstructive Surgery Department, Institut Curie, Ear, Nose & Throat, Paris, France
| | - Alexandre Matet
- Ophthalmology and Ocular Oncology Department, Institut Curie, Paris, France
- Université Paris Cité, Paris, France
| | - Denis Malaise
- Ophthalmology and Ocular Oncology Department, Institut Curie, Paris, France
| | - Nathalie Cassoux
- Ophthalmology and Ocular Oncology Department, Institut Curie, Paris, France
- Université Paris Cité, Paris, France
| | - Rémi Dendale
- Radiation Oncology Department, Institut Curie, Paris, France
| | - Olivier Choussy
- Head & Neck Oncologic and Reconstructive Surgery Department, Institut Curie, Ear, Nose & Throat, Paris, France
| | - Nathalie Badois
- Head & Neck Oncologic and Reconstructive Surgery Department, Institut Curie, Ear, Nose & Throat, Paris, France
| |
Collapse
|
4
|
Nudelman NT, Ekhator N, Rothschild M, Wladis EJ. A SEER program study of survival trends in Merkel cell carcinoma of the eyelid: 2000-2019. Orbit 2024; 43:290-295. [PMID: 38032687 DOI: 10.1080/01676830.2023.2286380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 11/16/2023] [Indexed: 12/01/2023]
Abstract
PURPOSE Merkel cell carcinoma of the eyelid (MCCE) is a rare yet aggressive neuroendocrine tumour associated with significant morbidity and mortality. This study aimed to investigate survival trends and demographic factors related to MCCE, 2000-2019, using the Surveillance, Epidemiology, and End Results (SEER) Program. METHODS Cases were analysed by demographic parameters, disease properties, and survival. Statistical analyses were performed via a dedicated computerized software package. RESULTS A total 349 cases of MCCE were identified, accounting for 2% of all MCC cases in the United States during that time. Of note, the incidence of MCCE remained stable over the study period (p = .35). Female patients accounted for 56% of the cases, and males for 44%. White patients accounted for 90.8% of the the cases, and Black patients for 2.9%. MCCE incidence increased with age, with the majority of patients age 85+ (p < .05). Incidence was greatest in metropolitan areas and among those with median incomes >$75,000/year. Income correlated with likelihood of MCCE diagnosis (p < .05). Analysis of 5-year survival data showed 20% of the patients died due to MCCE within 5 years of diagnosis. Of these, the majority died within one year of diagnosis. CONCLUSIONS Consistent with previous reports, most patients were white, female, and age 85+.Incidence correlated with metropolitan environments and median income. While most patients did not die from MCCE, majority of recorded deaths occurred within one year of diagnosis.
Collapse
Affiliation(s)
- Nicole T Nudelman
- Department of Ophthalmology, Albany Medical College, Albany, New York, USA
| | - Nehikhare Ekhator
- Department of Ophthalmology, Albany Medical College, Albany, New York, USA
| | - Michael Rothschild
- Department of Ophthalmology, Albany Medical College, Albany, New York, USA
| | - Edward J Wladis
- Department of Ophthalmology, Albany Medical College, Albany, New York, USA
- Department of Otolaryngology, Albany Medical College, Albany, New York, USA
| |
Collapse
|
5
|
Patro KC, Avinash A, Banidutta A, Kundu CR, Bhattacharya PS, Pilaka VKR, Muvvala M, Kumar AA, Aketi S, Karthikeyan K, Madasu BK, Vincent DT. Implementing high-dose rate surface mould brachytherapy for carcinoma of eyelid: a practical approach and weekly review. Radiat Oncol J 2024; 42:154-159. [PMID: 38946078 PMCID: PMC11215503 DOI: 10.3857/roj.2023.00682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/08/2023] [Accepted: 12/08/2023] [Indexed: 07/02/2024] Open
Abstract
Surface mould brachytherapy is a conformal radiotherapy technique that can deliver high dose to the target while sparing nearby normal structures, Here, we aim to describe the procedurals details for high-dose rate (HDR) surface mould brachytherapy in sebaceous carcinoma of eyelid in a 54-year old lady. She was hesitant for surgery and any form of invasive intervention like interstitial brachytherapy. So, she was treated with surface mould HDR brachytherapy to a total dose of 52 Gy in 13 fractions at a dose of 4 Gy per fraction delivered twice daily using Iridium-192 isotope with no acute side effects. She was evaluated on a weekly basis for any radiation side effects and now she is disease-free for 6 months post-treatment with only mild dry eye. A detailed step-by-step procedure of surface mould technique, simulation procedure, dose prescription, planning, plan evaluation and treatment has been described in this paper. Surface mould HDR brachytherapy can be safely used as organ preserving modality of treatment for eyelid carcinoma.
Collapse
Affiliation(s)
- Kanhu Charan Patro
- Department of Radiation Oncology, Mahatma Gandhi Cancer Hospital and Research Institute, Visakhapatnam, Andhra Pradesh, India
| | - Ajitesh Avinash
- Department of Radiation Oncology, SUM Ultimate Medicare, Bhubaneswar, Odisha, India
| | - Arya Banidutta
- Department of Radiation Oncology, Utkal Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Chitta Ranjan Kundu
- Department of Radiation Oncology, Mahatma Gandhi Cancer Hospital and Research Institute, Visakhapatnam, Andhra Pradesh, India
| | - Partha Sarathi Bhattacharya
- Department of Radiation Oncology, Mahatma Gandhi Cancer Hospital and Research Institute, Visakhapatnam, Andhra Pradesh, India
| | - Venkata Krishna Reddy Pilaka
- Department of Radiation Oncology, Mahatma Gandhi Cancer Hospital and Research Institute, Visakhapatnam, Andhra Pradesh, India
| | - Mrutyunjayarao Muvvala
- Department of Radiation Oncology, Mahatma Gandhi Cancer Hospital and Research Institute, Visakhapatnam, Andhra Pradesh, India
| | - Ayyalasomayajula Anil Kumar
- Department of Medical Physics, Mahatma Gandhi Cancer Hospital and Research Institute, Visakhapatnam, Andhra Pradesh, India
| | - Srinu Aketi
- Department of Medical Physics, Mahatma Gandhi Cancer Hospital and Research Institute, Visakhapatnam, Andhra Pradesh, India
| | - Keerthiga Karthikeyan
- Department of Radiation Oncology, Mahatma Gandhi Cancer Hospital and Research Institute, Visakhapatnam, Andhra Pradesh, India
| | - Bhargava Krishna Madasu
- Department of Radiation Oncology, Mahatma Gandhi Cancer Hospital and Research Institute, Visakhapatnam, Andhra Pradesh, India
| | - Dona Treesa Vincent
- Department of Radiation Oncology, Mahatma Gandhi Cancer Hospital and Research Institute, Visakhapatnam, Andhra Pradesh, India
| |
Collapse
|
6
|
Dhillon J, Li DQ, Burnier M, Shenouda G, Arthurs BP, El-Hadad C. Cemiplimab for metastatic squamous cell carcinoma of the orbit, periocular adnexa, and thigh. Orbit 2024; 43:258-264. [PMID: 36052515 DOI: 10.1080/01676830.2022.2118789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 08/25/2022] [Indexed: 10/14/2022]
Abstract
The current case presentation highlights the potential of cemiplimab, a programmed cell death protein-1 (PD-1) inhibitor, as first-line treatment for periocular metastatic cutaneous squamous cell carcinoma (SCC) without requiring curative surgery or radiotherapy. A 64-year-old male presented with a progressing 4.5 × 3.0 cm left upper eyelid lesion initially diagnosed as psoriasis. Work-up revealed cutaneous SCC with tumor invasion into extraconal fat and lacrimal gland, and metastasis to the left parotid lymph node. The patient also presented with a suspicious lesion on his left medial thigh found to be a second primary on pathology. To avoid orbital exenteration and treat the multifocal disease, the patient was started on intravenous cemiplimab immunotherapy. Following six doses, repeated FGD-PET-CT revealed a complete response of the left eyelid lesion and residual low-grade hypermetabolic activity of the left medial thigh lesion. Biopsy confirmed chronic inflammation and fibrosis with no signs of malignancy. This unique case with dual primary cutaneous SCC provides support for cemiplimab in treating locally invasive periocular SCC, and potentially abrogating the need for highly morbid exenteration procedures to preserve binocular vision.
Collapse
Affiliation(s)
- Jobanpreet Dhillon
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, USA
| | - Daniel Q Li
- Department of Ophthalmology & Visual Sciences, McGill University, Montreal, QC, USA
| | - Miguel Burnier
- Department of Ophthalmology & Visual Sciences, McGill University, Montreal, QC, USA
| | - George Shenouda
- Department of Radiation Oncology, McGill University, Montreal, QC, USA
| | - Bryan P Arthurs
- Department of Ophthalmology & Visual Sciences, McGill University, Montreal, QC, USA
| | - Christian El-Hadad
- Department of Ophthalmology & Visual Sciences, McGill University, Montreal, QC, USA
| |
Collapse
|
7
|
Schoelles KJ, Auw-Haedrich C. Updates on eyelid cancers. Asia Pac J Ophthalmol (Phila) 2024; 13:100057. [PMID: 38615904 DOI: 10.1016/j.apjo.2024.100057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/16/2024] Open
Abstract
In this review, we aim to provide an overview of the five most common malignant eyelid tumors with current treatment recommendations based on international guidelines. Particular attention is paid to the clinicopathological correlation and the update with regard to adequate treatment. Newer systemic therapies enrich the existing treatment options, of which complete tumor excision remains the most important therapeutic measure.
Collapse
|
8
|
Shaker N, Sangueza OP, Shaker N, Pradhan D. Extra-Ocular Sebaceous Carcinoma in Situ of the Arm of an Elder Male: An Unusual Presentation in an Atypical Location. Int J Surg Pathol 2024:10668969241226701. [PMID: 38295361 DOI: 10.1177/10668969241226701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
Background. Sebaceous carcinoma in situ outside the ocular region is an exceedingly uncommon. It is an intraepidermal neoplasm originating from sebaceous glands limited to the epidermis with no invasion into the underlying dermis or beyond. Although sebaceous carcinoma in situ is predominantly observed in ocular regions, particularly the eyelids, instances of its occurrence in extraocular locations are infrequent, with only a limited number of examples reported in the literature. Case Presentation. A 63-year-old man presented with a left posterior arm lesion. Microscopic examination revealed a proliferation of poorly differentiated atypical neoplastic sebocytes confined to the epidermis with pleomorphic nuclei, prominent nucleoli, and clear cell changes. The neoplastic cells demonstrated positive staining for adipophilin, androgen receptor, epithelial membrane antigen, P63, BerEP4, and keratin 7. Microsatellite instability markers showed preserved nuclear staining for MLH1, PMS2, MSH2, and MSH6. A definitive diagnosis of sebaceous carcinoma in situ was rendered. Discussion. The distinctive histopathologic characteristics typically involve the presence of atypical sebaceous cells confined within the epidermis. Atypical cells often exhibit enlarged nuclei, increased mitotic activity, and prominent nucleoli. A panel of epithelial membrane antigen, adipophilin, and androgen receptors is essential for ensuring an accurate diagnosis. Conclusion. This report underscores the importance of considering sebaceous carcinoma in situ in diagnosis in atypical locations, emphasizing the need for a comprehensive histopathologic examination and immunohistochemical staining panel. This article aims to demonstrate the rarity of sebaceous carcinoma in situ in extraocular sites to broaden our understanding of its diverse clinical presentations.
Collapse
Affiliation(s)
- Nada Shaker
- Department of Pathology, The Ohio State University Wexner Medical Center/James Cancer Hospital, Columbus, OH, USA
| | - Omar P Sangueza
- Department of Pathology and Dermatology, Wake Forest University, School of Medicine Medical Center Boulevard, Winston-Salem, NC, USA
| | - Nuha Shaker
- University of Pittsburgh Medical Center Health System, Pittsburgh, PA, USA
| | | |
Collapse
|
9
|
Sato Y, Takahashi S, Toshiyasu T, Tsuji H, Hanai N, Homma A. Squamous cell carcinoma of the eyelid. Jpn J Clin Oncol 2024; 54:4-12. [PMID: 37747408 PMCID: PMC10773209 DOI: 10.1093/jjco/hyad127] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/30/2023] [Indexed: 09/26/2023] Open
Abstract
Eyelid squamous cell carcinoma is a major type of rare eyelid cancer, together with basal cell carcinoma and sebaceous gland carcinoma. It is a painless disease that progresses slowly and is often detected by the appearance of nodules or plaques. Risk factors include exposure to ultraviolet light, fair skin, radiation and human papillomavirus infection. The standard treatment is surgical removal, and in cases of orbital invasion, orbital content removal is required. If sentinel node biopsy reveals a high risk of lymph node metastasis, adjuvant radiotherapy may be considered. Local chemotherapy, such as imiquimod and 5-fluorouracil, may be used for eyelid squamous cell carcinoma in situ. When surgery or radiotherapy is not recommended for distant metastases or locally advanced disease, drug therapy is often according to head and neck squamous cell carcinoma in Japan. The treatment often requires a multidisciplinary team to ensure the preservation of function and cosmetic appearance.
Collapse
Affiliation(s)
- Yasuyoshi Sato
- Department of Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
- Department of Chemotherapy and Cancer Center, The University of Tokyo Hospital, Tokyo, Japan
| | - Shunji Takahashi
- Department of Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Takashi Toshiyasu
- Department of Radiation Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hideki Tsuji
- Department of Ophthalmology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Nobuhiro Hanai
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Akihiro Homma
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| |
Collapse
|
10
|
Hooper J, Shao K, Feng PW, Falcone M, Feng H. Periocular and ocular surface nonmelanoma skin cancer. Clin Dermatol 2024; 42:71-77. [PMID: 37866412 DOI: 10.1016/j.clindermatol.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
Periocular and ocular surface nonmelanoma malignancies, including basal cell carcinoma (BCC), squamous cell carcinomas (SCC), and ocular surface squamous neoplasia (OSSN), are rare, but their management requires special considerations. The most common periocular malignancy is BCC, which constitutes 80% to 96% of tumors, followed by SCC, which represents 5% to 10% of tumors. OSSN represents a spectrum of diseases that encompass dysplastic alteration to the squamous epithelium of the eye. OSSN ranges from squamous dysplasia to conjunctival intraepithelial neoplasia/carcinoma in situ to invasive SCC, which is the most common ocular malignancy. These tumors can be staged using the eighth edition of the American Joint Committee on Cancer categorization system. The standard of care for periocular malignancies is Mohs micrographic surgery, while medical management with 5-fluorouracil (5-FU), interferon alfa-2b (INF), and mitomycin C (MMC) or "no touch" surgical excision are options for OSSN. Systemic therapies, including sonic hedgehog inhibitors for BCC and epidermal growth factor inhibitors and immune-checkpoint inhibitors for SCC, can be utilized for advanced disease. Recurrence rates are higher for periorbital and ocular malignancies than their respective cutaneous counterparts. These carcinomas and their respective treatments have unique side effects and considerations in an effort to preserve visual function.
Collapse
Affiliation(s)
- Jette Hooper
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut, USA
| | - Kimberly Shao
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut, USA
| | - Paula W Feng
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Madina Falcone
- Department of Surgery, Division of Ophthalmology, University of Connecticut Health Center, Farmington, Connecticut, USA
| | - Hao Feng
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut, USA.
| |
Collapse
|
11
|
Kakkar A, Srivastava K, Deepa S, Kashyap S, Sen S, Bhoriwal S, Kaur K, Deo SVS. HPV-Associated Squamous Cell Carcinoma of the Eyelid: Diagnostic Utility of p16 Immunohistochemistry and mRNA In Situ Hybridization. Head Neck Pathol 2023; 17:889-898. [PMID: 37735287 PMCID: PMC10739694 DOI: 10.1007/s12105-023-01582-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 08/28/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND High-risk (HR) Human papillomavirus (HPV) has been implicated in pathogenesis of squamous cell carcinomas (SCC) at several sites with mucocutaneous junctions, including the head and neck. SCC is the second most common eyelid malignancy. However, its association with transcriptionally active HR-HPV has not been adequately studied. METHODS Two index cases of eyelid HPV-associated SCC are described in detail. A retrospective cohort of eyelid SCC was examined for p16 immunoexpression. Cases demonstrating p16 positivity or equivocal staining were subjected to high-risk HPV mRNA in situ hybridization (ISH). Quantitative real-time PCR (qPCR) was performed in mRNA ISH-positive cases for HPV genotyping. RESULTS The two index patients were older adult females, with upper eyelid tumours. On histology, both tumours were non-keratinizing SCC with trabecular and nested architecture reminiscent of oropharyngeal HPV-associated non-keratinizing SCC, prompting p16 immunohistochemistry, which was positive. HR-HPV mRNA ISH was positive, and qPCR detected HPV16 in both cases. Three of 20 (15%) archival cases showed p16 immunopositivity and two (10%) showed equivocal staining. However, mRNA ISH was negative. All cases showing p16 immunostaining and lacking HR-HPV were keratinizing SCCs. Thus, 9% of all eyelid SCC examined demonstrated HR-HPV. CONCLUSION The prevalence of HR-HPV in eyelid SCC is low in Indian patients. HPV-associated SCC may mimic commoner eyelid carcinomas as it lacks overt keratinization. In basaloid-appearing eyelid carcinomas, p16 immunopositivity should be followed by reflex HR-HPV mRNA ISH, as p16 immunohistochemistry alone has low specificity. The prognostic role, if any, of HPV association needs further evaluation.
Collapse
Affiliation(s)
- Aanchal Kakkar
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - Kirti Srivastava
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - S Deepa
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Seema Kashyap
- Division of Ocular Pathology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Seema Sen
- Division of Ocular Pathology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Sandeep Bhoriwal
- Department of Surgical Oncology, IRCH, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Kavneet Kaur
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Suryanarayan V S Deo
- Department of Surgical Oncology, IRCH, All India Institute of Medical Sciences, New Delhi, 110029, India
| |
Collapse
|
12
|
Sangiorgi E, Giannuzzi F, Molinario C, Rapari G, Riccio M, Cuffaro G, Castri F, Benvenuto R, Genuardi M, Massi D, Savino G. Base-Excision Repair Mutational Signature in Two Sebaceous Carcinomas of the Eyelid. Genes (Basel) 2023; 14:2055. [PMID: 38002998 PMCID: PMC10671510 DOI: 10.3390/genes14112055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
Personalized medicine aims to develop tailored treatments for individual patients based on specific mutations present in the affected organ. This approach has proven paramount in cancer treatment, as each tumor carries distinct driver mutations that respond to targeted drugs and, in some cases, may confer resistance to other therapies. Particularly for rare conditions, personalized medicine has the potential to revolutionize treatment strategies. Rare cancers often lack extensive datasets of molecular and pathological information, large-scale trials for novel therapies, and established treatment guidelines. Consequently, surgery is frequently the only viable option for many rare tumors, when feasible, as traditional multimodal approaches employed for more common cancers often play a limited role. Sebaceous carcinoma of the eyelid is an exceptionally rare cancer affecting the eye's adnexal tissues, most frequently reported in Asia, but whose prevalence is significantly increasing even in Europe and the US. The sole established curative treatment is surgical excision, which can lead to significant disfigurement. In cases of metastatic sebaceous carcinoma, validated drug options are currently lacking. In this project, we set out to characterize the mutational landscape of two sebaceous carcinomas of the eyelid following surgical excision. Utilizing available bioinformatics tools, we demonstrated our ability to identify common features promptly and accurately in both tumors. These features included a Base-Excision Repair mutational signature, a notably high tumor mutational burden, and key driver mutations in somatic tissues. These findings had not been previously reported in similar studies. This report underscores how, in the case of rare tumors, it is possible to comprehensively characterize the mutational landscape of each individual case, potentially opening doors to targeted therapeutic options.
Collapse
Affiliation(s)
- Eugenio Sangiorgi
- Sezione di Medicina Genomica, Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (G.R.); (M.R.); (M.G.)
| | - Federico Giannuzzi
- Ocular Oncology Unit, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (F.G.); (G.C.); (G.S.)
| | - Clelia Molinario
- Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (C.M.); (F.C.); (R.B.)
| | - Giulia Rapari
- Sezione di Medicina Genomica, Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (G.R.); (M.R.); (M.G.)
| | - Melania Riccio
- Sezione di Medicina Genomica, Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (G.R.); (M.R.); (M.G.)
| | - Giovanni Cuffaro
- Ocular Oncology Unit, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (F.G.); (G.C.); (G.S.)
| | - Federica Castri
- Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (C.M.); (F.C.); (R.B.)
| | - Roberta Benvenuto
- Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (C.M.); (F.C.); (R.B.)
| | - Maurizio Genuardi
- Sezione di Medicina Genomica, Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (G.R.); (M.R.); (M.G.)
- UOC Genetica Medica, Fondazione Policlinico Universitario A. Gemelli-IRCCS, 00168 Roma, Italy
| | - Daniela Massi
- Section of Pathology, Department of Health Sciences, University of Florence, 50121 Florence, Italy;
| | - Gustavo Savino
- Ocular Oncology Unit, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (F.G.); (G.C.); (G.S.)
| |
Collapse
|
13
|
Bergmann MJ, de Keizer ROB, Paridaens D. Globe-sparing surgical treatment for periocular malignancies with anterior orbital invasion: a consecutive case series. Orbit 2023; 42:536-544. [PMID: 36617852 DOI: 10.1080/01676830.2022.2141803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 10/25/2022] [Indexed: 01/10/2023]
Abstract
PURPOSE Orbital exenteration of periocular tumors complicated by orbital invasion is a heavy burden for patients and leads to disfiguring cosmesis and loss of vision. Here, we report our experience with globe-sparing surgery in a series of patients with periocular malignancies other than basal cell carcinoma (BCC), all exhibiting anterior orbital invasion. METHODS In this consecutive case series, we examined medical records of all patients between 2000 and 2018 with periocular malignancies (other than BCC) invading the anterior orbit (without extraocular muscle or scleral invasion) treated by one orbital surgeon (DP). The main outcome measures included local recurrence, regional and distant metastasis, survival, and visual acuity. RESULTS Nine patients were identified. Of the non-BCC cancers invading the orbit, squamous cell carcinoma (SCC) (44.4%) was the most prevalent type in our series. Excision included the removal of visibly distinguishable tumor and a free clinical margin of up to 5 mm with histological confirmation of radicality of the invasive tumor component. Reconstruction was achieved by a variety of oculoplastic reconstructive procedures. At a mean follow-up of 70 months (range 11-177 months), 8 out of 9 patients were still alive. Recurrence occurred in two patients with conjunctival melanoma (CM), and they were again treated with wide excision. Postoperative visual acuity remained stable or improved. CONCLUSION This retrospective case series demonstrates that globe-sparing excisional surgery can be considered in selected cases of periocular malignancies other than BCC with anterior orbital invasion, thus avoiding cosmetic disfigurement and loss of vision due to orbital exenteration.
Collapse
Affiliation(s)
- Michael Jan Bergmann
- Department of Orbital Oculoplastic and Lacrimal Surgery, The Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - Ronald Olaf Björn de Keizer
- Department of Orbital Oculoplastic and Lacrimal Surgery, The Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - Dion Paridaens
- Department of Orbital Oculoplastic and Lacrimal Surgery, The Rotterdam Eye Hospital, Rotterdam, The Netherlands
| |
Collapse
|
14
|
Zhao Y, Bai R, Hao H, Qi W, Li S, Li J. The effectiveness and safety of eyelid defect reconstruction after sebaceous carcinoma of the eyelid surgery: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e34531. [PMID: 37565911 PMCID: PMC10419430 DOI: 10.1097/md.0000000000034531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 08/12/2023] Open
Abstract
INTRODUCTION Sebaceous carcinoma of the eyelid is the third most common eyelid malignancy, after basal cell carcinoma and squamous cell carcinoma. It is highly malignant and potentially aggressive. Surgical excision is currently the best treatment option for this condition. Patients often require reconstruction surgery to repair eyelid defects to achieve normal eyelid function and appearance. However, no comprehensive systematic review has assessed the efficacy and safety of eyelid defect reconstruction. This protocol was developed to conduct a systematic review and meta-analysis to evaluate evidence related to the efficacy and safety of reconstruction. METHODS We will systematically search the Cochrane Library, PubMed, Web of Science, China National Knowledge Infrastructure, WanFang Database, and Chinese Biomedical Literature Database from their inception to February 2023 for studies on eyelid defect reconstruction. We will identify other potential studies using multiple methods such as manual searching. The outcomes were eyelid function, eyelid morphology, patient satisfaction, recurrence rate, metastasis rate, tumor-related mortality, and adverse events. Two researchers will independently screen titles and abstracts, identify full-text studies for inclusion, extract data, and appraise the risk of bias in the included studies. A meta-analysis will be conducted using Review Manager 5.4 and R software. The certainty of evidence will be appraised by grading of recommendations, assessment, development, and evaluation system. RESULTS This full-text will adhere to the preferred reporting items for systematic reviews and meta-analyses statement to ensure clarity and completeness of reporting in all phases of the systematic review. DISCUSSION This study provides evidence of the efficacy and safety of reconstruction methods for sebaceous carcinoma of the eyelid.
Collapse
Affiliation(s)
- Yu Zhao
- Department of Ophthalmology, Lanzhou First People’s Hospital, Lanzhou, China
| | - Rong Bai
- Department of Ophthalmology, Lanzhou First People’s Hospital, Lanzhou, China
| | - Hongyan Hao
- Department of Ophthalmology, Lanzhou First People’s Hospital, Lanzhou, China
| | - Wei Qi
- Department of Ophthalmology, Lanzhou First People’s Hospital, Lanzhou, China
| | - Sheng Li
- Department of Ophthalmology, Lanzhou First People’s Hospital, Lanzhou, China
| | - Jun Li
- Department of Ophthalmology, Lanzhou First People’s Hospital, Lanzhou, China
| |
Collapse
|
15
|
Nie Z, Geng J, Xu X, Zhang R, Li D. Development and validation of a nomogram to predict the recurrence of eyelid sebaceous gland carcinoma. Cancer Med 2023; 12:14912-14921. [PMID: 37387455 PMCID: PMC10417194 DOI: 10.1002/cam4.6126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 05/05/2023] [Accepted: 05/14/2023] [Indexed: 07/01/2023] Open
Abstract
PURPOSE Eyelid sebaceous gland carcinoma (SGC) is a malignancy with fatal risk, high recurrence rate, and pagetoid spread. Thus, recurrence risk prediction and prompt treatment are extremely important. This study aimed to develop a nomogram to predict SGC recurrence based on potential risk factors. METHODS We conducted a retrospective study to train and test a nomogram based on the clinical data of 391 patients across our hospital (304) and other grass-roots hospitals (87). After Cox regression, predictors included in the nomogram were selected, and sensitivity, specificity, concordance index (C-index), etc., were calculated to test their discrimination ability. RESULTS After a median follow-up period of 4.12 years, SGC recurred in 52 (17.11%) patients. The 1-, 2-, and 5-year recurrence-free survival rates were 88.3%, 85.4%, and 81.6%, respectively. We examined five risk factors, such as lymph node metastasis at initial diagnosis (hazard ratio [HR], 2.260; 95% confidence interval [CI], 1.021-5.007), Ki67 (HR, 1.036; 95% CI, 1.020-1.052), histology differentiation degree (HR, 2.274; 95% CI, 1.063-4.865), conjunctival pagetoid infiltration (HR, 2.100; 95% CI, 1.0058-4.167), and orbital involvement (HR, 4.764; 95% CI, 1.436-15.803). The model had good discrimination in both internal and external test sets. The model had good discrimination in both internal and external test sets. The sensitivity of the internal test and external test set were 0.722 and 0.806, respectively, and specificity of the internal test and external test set were 0.886 and 0.893, respectively. CONCLUSION We examined the potential risk factors for eyelid SGC recurrence and constructed a nomogram, which complements the TNM system in terms of prediction, indicating that our nomogram has the potential to reach clinical significance. This nomogram has the potential to assist healthcare practitioners in promptly detecting patients who are at an elevated risk and in tailoring clinical interventions to meet their individualized needs.
Collapse
Affiliation(s)
- Zihan Nie
- Beijing Ophthalmology & Visual Science Key LaboratoryBeijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical UniversityBeijingChina
| | - Jialu Geng
- Beijing Ophthalmology & Visual Science Key LaboratoryBeijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical UniversityBeijingChina
| | - Xiaolin Xu
- Beijing Ophthalmology & Visual Science Key LaboratoryBeijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical UniversityBeijingChina
| | - Ruiheng Zhang
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology&Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information TechnologyBeijing Tongren Hospital, Capital Medical UniversityBeijingChina
| | - Dongmei Li
- Beijing Ophthalmology & Visual Science Key LaboratoryBeijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical UniversityBeijingChina
- Dong Jiao Min LaneBeijingChina
| |
Collapse
|
16
|
Lin Y, Liu X, Zhang Y, Xie Z, Fang X, Shi K, Zhong Y, Su S, Cai M, Wu H, Ou S. The clinicopathological analysis of ocular and orbit tumors in southeast of China. Front Oncol 2023; 13:1118862. [PMID: 37404770 PMCID: PMC10316389 DOI: 10.3389/fonc.2023.1118862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 04/21/2023] [Indexed: 07/06/2023] Open
Abstract
Purpose The purpose of this study is to describe the clinicopathologic characteristics of ocular surface and orbit tumors in the Southeast of China and explore the method to differentiate the benign and malignant masses. Materials and methods 3468 patients undergoing mass resection from January 2015 to December 2020 were selected as observation subjects and were classified into benign and malignant masses according to postoperative pathology. The clinicopathologic characteristics were collected, including gender, age, pathological tissue signs, and pathological signs. Multivariate Logistic regression analysis of independent risk factors of malignant mass was applied to establish a diagnostic model and the efficacy was evaluated by the subject working characteristics (ROC) curve. Results Benign tumors accounted for 91.5% of all cases, and malignant tumors accounted for 8.5%. The most common ocular benign tumors were nevi (24.2%), granuloma (17.1%), and cysts (16.4%). The most common ocular malignant tumors were malignant lymphoma (32.1%) and Basal cell carcinoma (20.2%). As for the histologic origin, melanocytic origin was on the list with 819 (23.6%), mesenchymal 661 (19.1%), epithelial 568 (16.3%), cystic 521 (15.0%), skin adnexal 110 (3.1%), lymphoid 94 (2.8%), and Neural 25(0.8%). Based on the gender, age, tumor location, and the pathological tissue image feature (including differentiation, structural atypia, covering epithelial, keratosis, nest structure/distribution, nuclear atypia, cytoplasmic change and nuclear division), the diagnostic model had predictive value to differentiate the benign and malignant masses. Conclusion Most ocular surface and orbit tumors are benign. Tumor diagnosis is relative to the patient's age, gender, tumor location, and pathologic characteristics. We generated a satisfactory diagnostic model to differential diagnosis of benign and malignant masses.
Collapse
Affiliation(s)
- Yuan Lin
- Eye Institute of Xiamen University and affiliated Xiamen Eye Center, School of Medicine, Xiamen University, Xiamen, Fujian, China
- Fujian Provincial Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, Fujian, China
| | - Xiaodong Liu
- Eye Institute of Xiamen University and affiliated Xiamen Eye Center, School of Medicine, Xiamen University, Xiamen, Fujian, China
- Fujian Provincial Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, Fujian, China
| | - Yujie Zhang
- Eye Institute of Xiamen University and affiliated Xiamen Eye Center, School of Medicine, Xiamen University, Xiamen, Fujian, China
- Fujian Provincial Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, Fujian, China
| | - Zhiwen Xie
- Eye Institute of Xiamen University and affiliated Xiamen Eye Center, School of Medicine, Xiamen University, Xiamen, Fujian, China
- Fujian Provincial Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, Fujian, China
| | - Xie Fang
- Eye Institute of Xiamen University and affiliated Xiamen Eye Center, School of Medicine, Xiamen University, Xiamen, Fujian, China
- Fujian Provincial Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, Fujian, China
| | - Ke Shi
- Eye Institute of Xiamen University and affiliated Xiamen Eye Center, School of Medicine, Xiamen University, Xiamen, Fujian, China
- Fujian Provincial Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, Fujian, China
| | - Yanlin Zhong
- Eye Institute of Xiamen University and affiliated Xiamen Eye Center, School of Medicine, Xiamen University, Xiamen, Fujian, China
- Fujian Provincial Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, Fujian, China
| | - Shengqi Su
- Eye Institute of Xiamen University and affiliated Xiamen Eye Center, School of Medicine, Xiamen University, Xiamen, Fujian, China
- Fujian Provincial Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, Fujian, China
- Xiamen Science and Technology Middle School, Xiamen, Fujian, China
| | - Minqing Cai
- Eye Institute of Xiamen University and affiliated Xiamen Eye Center, School of Medicine, Xiamen University, Xiamen, Fujian, China
- Fujian Provincial Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, Fujian, China
| | - Huping Wu
- Eye Institute of Xiamen University and affiliated Xiamen Eye Center, School of Medicine, Xiamen University, Xiamen, Fujian, China
- Fujian Provincial Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, Fujian, China
| | - Shangkun Ou
- Eye Institute of Xiamen University and affiliated Xiamen Eye Center, School of Medicine, Xiamen University, Xiamen, Fujian, China
- Fujian Provincial Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, Fujian, China
| |
Collapse
|
17
|
Larnaudie A, Giraud P, Naessens C, Stefan D, Clavère P, Balosso J. Radiotherapy of skin adnexal carcinoma. Cancer Radiother 2023:S1278-3218(23)00062-8. [PMID: 37080860 DOI: 10.1016/j.canrad.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 04/22/2023]
Abstract
Skin adnexal carcinomas are rare skin cancer, developing from pilosebaceous, eccrine and apocrine unit. Treatment of localised tumours usually includes surgery and radiotherapy. Indications and modalities of radiotherapy depend on the pathological subtype with a lack of consensus for some histologies. This review summarises the place of radiotherapy in terms of indication, dose and fractionation, volumes to irradiate and discuss ongoing studies.
Collapse
Affiliation(s)
- A Larnaudie
- Department of Radiation Oncology, centre François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France; Department of Radiation Oncology, Dupuytren University Hospital, 2, avenue Martin-Luther-King, 87000 Limoges, France.
| | - P Giraud
- Radiation Oncology, Pitié Salpêtrière, Charles-Foix University Hospital, 47-83, boulevard de l'hôpital, 75013 Paris, France; Médecine Sorbonne universités, 91-105, boulevard de l'hôpital, 75013 Paris, France
| | - C Naessens
- Department of Radiation Oncology, Dupuytren University Hospital, 2, avenue Martin-Luther-King, 87000 Limoges, France
| | - D Stefan
- Department of Radiation Oncology, centre François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France
| | - P Clavère
- Department of Radiation Oncology, Dupuytren University Hospital, 2, avenue Martin-Luther-King, 87000 Limoges, France
| | - J Balosso
- Department of Radiation Oncology, centre François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France
| |
Collapse
|
18
|
Goldfarb JA, Ferrarotto R, Gross N, Goepfert R, Debnam JM, Gunn B, Nagarajan P, Esmaeli B. Immune checkpoint inhibitors for treatment of periorbital squamous cell carcinoma. Br J Ophthalmol 2023; 107:320-323. [PMID: 34625433 DOI: 10.1136/bjophthalmol-2021-319417] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 09/27/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE To report on the outcomes of immunotherapy in patients with locally advanced periorbital squamous cell carcinoma. METHODS We performed a retrospective chart review of seven consecutive patients with locally advanced periorbital cutaneous squamous cell carcinoma treated with anti-PD-1 immunotherapy. Treatments and therapeutic outcomes were reviewed. RESULTS Of the seven patients, six were treated with cemiplimab, and one was treated with pembrolizumab. Five patients were treated with immunotherapy as neoadjuvant therapy before planned surgical resection; two patients received immunotherapy for treatment of advanced recurrent lesions deemed unresectable following multiple previous excisions and radiation therapy. In all seven patients, measurable clinical and/or radiologic response was observed. CONCLUSIONS Our findings support the emerging role of anti-PD-1 immunotherapy in the management of locally advanced periorbital cutaneous squamous cell carcinoma.
Collapse
Affiliation(s)
- Jeremy Allan Goldfarb
- Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Renata Ferrarotto
- Department of Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Neil Gross
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ryan Goepfert
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - James Matthew Debnam
- Department of Neuroradiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Brandon Gunn
- Department of Radiation Oncology, The University of Texas MD Anderson Division of Radiation Oncology, Houston, Texas, USA
| | - Priyadharsini Nagarajan
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Bita Esmaeli
- Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
19
|
Steren B, Burtness B, Bhatia A, Demirci H, Shinder R, Yoo D, Tse B, Pointdujour-Lim R. Cemiplimab for Orbital Squamous Cell Carcinoma in 11 Cases. Ophthalmic Plast Reconstr Surg 2022; 38:496-502. [PMID: 35502804 DOI: 10.1097/iop.0000000000002190] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To review the demographics, clinical features, and response of orbital squamous cell carcinoma treated with cemiplimab. METHODS This is a retrospective multi-institutional series. Patient characteristics, drug dosing, duration, and response to treatment were evaluated. RESULTS The study cohort consisted of 11 patients from 5 institutions. All patients received a regimen of 350 mg q 3 weeks and an average of 11.2 cycles (SD 5.8). No patient experienced significant side effects requiring treatment or cessation of cemiplimab. Complete response was achieved in 9 patients (82%) treated with cemiplimab. CONCLUSIONS Immune checkpoint inhibitors, such as cemiplimab provide a globe-sparing option for the treatment of orbital squamous cell carcinoma. It is important to consider these agents especially when orbital exenteration is the alternative.
Collapse
Affiliation(s)
- Benjamin Steren
- Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven
| | - Barbara Burtness
- Department of Medicine, Yale University School of Medicine and Yale Cancer Center, New Haven, CT, U.S.A
| | - Aarti Bhatia
- Department of Internal Medicine, Yale Cancer Center, New Haven, CT, United States; Yale University School of Medicine, U.S.A
| | - Hakan Demirci
- Department of Ophthalmology and Visual Science, Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, U.S.A
| | - Roman Shinder
- Department of Ophthalmology and Visual Science, SUNY Downstate, Brooklyn, New York, U.S.A
| | - David Yoo
- Department of Ophthalmology and Visual Science, Loyola University Medical Center, Maywood, Illinois, U.S.A
| | - Brian Tse
- Department of Ophthalmology and Visual Science, Bascom Palmer Eye Institute, University of Miami, Miami, Florida, U.S.A
| | - Renelle Pointdujour-Lim
- Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven
- Yale Smilow Cancer Center, New Haven, CT, U.S.A
| |
Collapse
|
20
|
Kumar T, Tewari P, Khanna N, Surabhi, Bharti S, Sinha R, Bhadani PP. Cytomorphology of sebaceous carcinoma of the eyelid: A short series of three cases with literature review. Diagn Cytopathol 2022; 50:E361-E366. [PMID: 35932255 DOI: 10.1002/dc.25029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 07/22/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Ocular sebaceous carcinoma (OSC) is a malignant and potentially lethal sebaceous gland tumor. Clinically, it masquerades as other benign and less malignant lesions, resulting in a delay in diagnosis. METHODS In the present study, we sought to evaluate the cytomorphology of this aggressive neoplasm diagnosed by fine-needle aspiration cytology (FNAC) last year at our institute. RESULTS/FINDINGS We report three cases of OSC diagnosed on aspiration cytology showed a cellular smear composed of sheets, 3D clusters, papillaroid, and singly scattered polygonal tumor cells having centrally located hyperchromatic pleomorphic nuclei and multiple microvacuolations in the cytoplasm. Necrosis and crushing artifact were also identified. Special stains such as Oil Red O stain on air-dried smears showed positivity, confirming the presence of lipid globules. Subsequently, the Cytological impression of sebaceous carcinoma was confirmed on histopathology. CONCLUSIONS The article highlights the role of FNAC in the early and correct diagnosis of aggressive tumors and subsequent appropriate management to prevent recurrence and metastasis.
Collapse
Affiliation(s)
- Tarun Kumar
- Department of Pathology/Lab Medicine, All India Institute of Medical Science, Patna, India
| | - Prerna Tewari
- Department of Pathology/Lab Medicine, All India Institute of Medical Science, Patna, India
| | - Nisha Khanna
- Department of Pathology/Lab Medicine, All India Institute of Medical Science, Patna, India
| | - Surabhi
- Department of Pathology/Lab Medicine, All India Institute of Medical Science, Patna, India
| | - Shreekant Bharti
- Department of Pathology/Lab Medicine, All India Institute of Medical Science, Patna, India
| | - Ruchi Sinha
- Department of Pathology/Lab Medicine, All India Institute of Medical Science, Patna, India
| | - Punam Prasad Bhadani
- Department of Pathology/Lab Medicine, All India Institute of Medical Science, Patna, India
| |
Collapse
|
21
|
Peterson C, Parikh RN, Ahmad MT, Campbell AA, Daoud Y, Mahoney N, Siadati S, Eberhart CG. Detection of Human Papillomavirus in Squamous Lesions of the Conjunctiva Using RNA and DNA In-Situ Hybridization. Int J Mol Sci 2022; 23:ijms23137249. [PMID: 35806252 PMCID: PMC9266440 DOI: 10.3390/ijms23137249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/24/2022] [Accepted: 06/28/2022] [Indexed: 02/04/2023] Open
Abstract
In-situ hybridization provides a convenient and reliable method to detect human papillomavirus (HPV) infection in formalin-fixed paraffin-embedded tissue. Cases of conjunctival papillomas, conjunctival intraepithelial neoplasia (CIN), conjunctival carcinoma in situ (cCIS), and invasive squamous cell carcinoma (SCC), in which low-risk (LR) and/or high-risk (HR) HPV types were evaluated by RNA or DNA in-situ hybridization, were retrospectively identified. LR HPV types were frequently detected in conjunctival papillomas (25/30, 83%), including 17/18 (94%) with RNA probes, compared to 8/12 (75%) with DNA probes. None of the CIN/cCIS or SCC cases were positive for LR HPV by either method. HR HPV was detected by RNA in-situ hybridization in 1/16 (6%) of CIN/cCIS cases and 2/4 (50%) of SCC cases, while DNA in-situ hybridization failed to detect HPV infection in any of the CIN/cCIS lesions. Reactive atypia and dysplasia observed in papillomas was generally associated with the detection of LR HPV types. Collectively, our findings indicate RNA in-situ hybridization may provide a high-sensitivity approach for identifying HPV infection in squamous lesions of the conjunctiva and facilitate the distinction between reactive atypia and true dysplasia. There was no clear association between HPV infection and atopy in papillomas or dysplastic lesions.
Collapse
Affiliation(s)
- Cornelia Peterson
- Department of Molecular and Comparative Pathobiology, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA;
| | - Rupin N. Parikh
- Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (R.N.P.); (M.T.A.); (A.A.C.); (Y.D.); (N.M.)
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA;
| | - Meleha T. Ahmad
- Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (R.N.P.); (M.T.A.); (A.A.C.); (Y.D.); (N.M.)
| | - Ashley A. Campbell
- Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (R.N.P.); (M.T.A.); (A.A.C.); (Y.D.); (N.M.)
| | - Yassine Daoud
- Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (R.N.P.); (M.T.A.); (A.A.C.); (Y.D.); (N.M.)
| | - Nicholas Mahoney
- Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (R.N.P.); (M.T.A.); (A.A.C.); (Y.D.); (N.M.)
| | - Sepideh Siadati
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA;
| | - Charles G. Eberhart
- Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (R.N.P.); (M.T.A.); (A.A.C.); (Y.D.); (N.M.)
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA;
- Correspondence: ; Tel.: +1-(410)-502-5185
| |
Collapse
|
22
|
Artificial intelligence to detect malignant eyelid tumors from photographic images. NPJ Digit Med 2022; 5:23. [PMID: 35236921 PMCID: PMC8891262 DOI: 10.1038/s41746-022-00571-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 02/04/2022] [Indexed: 11/23/2022] Open
Abstract
Malignant eyelid tumors can invade adjacent structures and pose a threat to vision and even life. Early identification of malignant eyelid tumors is crucial to avoiding substantial morbidity and mortality. However, differentiating malignant eyelid tumors from benign ones can be challenging for primary care physicians and even some ophthalmologists. Here, based on 1,417 photographic images from 851 patients across three hospitals, we developed an artificial intelligence system using a faster region-based convolutional neural network and deep learning classification networks to automatically locate eyelid tumors and then distinguish between malignant and benign eyelid tumors. The system performed well in both internal and external test sets (AUCs ranged from 0.899 to 0.955). The performance of the system is comparable to that of a senior ophthalmologist, indicating that this system has the potential to be used at the screening stage for promoting the early detection and treatment of malignant eyelid tumors.
Collapse
|
23
|
Ma R, Li X, Gan L, Guo J, Qian J. Modified procedure of anterior orbital exenteration enables eye socket reconstruction: A retrospective cohort study. Medicine (Baltimore) 2022; 101:e28698. [PMID: 35089227 PMCID: PMC8797479 DOI: 10.1097/md.0000000000028698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 01/10/2022] [Indexed: 01/05/2023] Open
Abstract
The conventional procedure of anterior orbital exenteration is unfavorable for eye socket reconstruction, whereas a modified procedure enables socket reconstruction and prosthesis fitting. Our study aims to compare the cosmetic outcomes between these 2 surgical techniques.We retrospectively recruited patients treated with modified or conventional exenteration during January 2015 to May 2021 in our hospital. The conventional approach was performed along with dermis-fat graft transplantation. The modified approach was conducted followed by eye socket reconstruction and eyelid blepharoplasty. The clinical data were collected and analyzed, including demographics, tumor characteristics, postoperative complications, tumor-related events, and cosmetic outcomes.Forty-nine patients were consecutively recruited in this study, including 22 cases of modified exenteration and 27 cases of conventional exenteration. Forty-four subjects (89.8%) were diagnosed with ocular surface malignancies (conjunctival melanoma and squamous cell carcinoma) and 5 subjects (10.2%) were diagnosed with extraocular stage of uveal melanoma. After follow-up for 31.8 ± 17.1 months, the 1-, 2-, 5-year overall survival rate was calculated as 100%, 79.2%, and 59.2% in the Modified group, and 94.2%, 73.8%, and 51.5% in the Conventional group. Comparison of the survival curves showed no significant differences. In the Modified group, all patients received orbital implant placement and eye socket reconstruction. The implant motility was satisfactory in 12 cases (54.5%) with movements in 3 to 4 directions. The eyelid function was acceptable in 17 cases (77.3%) with no entropion, ectropion or lower lid laxity. Ocular prosthesis was delivered in 17 cases (77.3%) with successful fitting in 11 cases (64.7%). The self-rated cosmetic score was statistically (t test, P < .0001) higher in the Modified group (6.7 ± 0.9) than the Conventional group (2.2 ± 0.4).The modified approach to anterior orbital exenteration enables eye socket reconstruction and cosmetic rehabilitation while still preserves the curable chance for the treatment of advanced periocular/intraocular malignancies.
Collapse
Affiliation(s)
- Ruiqi Ma
- Department of Ophthalmology, Fudan Eye & ENT Hospital, Shanghai, China
- Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xiaofeng Li
- Department of Ophthalmology, Fudan Eye & ENT Hospital, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
| | - Lu Gan
- Department of Ophthalmology, Fudan Eye & ENT Hospital, Shanghai, China
- Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Jie Guo
- Department of Ophthalmology, Fudan Eye & ENT Hospital, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
| | - Jiang Qian
- Department of Ophthalmology, Fudan Eye & ENT Hospital, Shanghai, China
| |
Collapse
|
24
|
García RLB, Jimenez J, Gubbay C, Castañeda JF, Granados Á. Squamous cell carcinoma of the conjunctiva. Case report. Int J Surg Case Rep 2022; 91:106785. [PMID: 35093703 PMCID: PMC8808077 DOI: 10.1016/j.ijscr.2022.106785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/13/2022] [Accepted: 01/20/2022] [Indexed: 11/26/2022] Open
Abstract
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. Squamous cell carcinoma is the most frequent tumor of the eyeball. The most important risk factor is the exposure to UV rays (damage in repairing DNA). There are topical management protocols with multiple chemotherapeutic agents. In patients with ocular or orbital invasion, the surgery is the GOLD standard of care. Adjuvant therapies are useful tools in the oncological management of these patients.
Collapse
Affiliation(s)
- Rogers Leonardo Baquero García
- San José Hospital, Fundación Universitaria de Ciencias de la Salud (University Foundation of Health Sciences), FUCS, Colombia.
| | - Julián Jimenez
- San José Hospital, Fundación Universitaria de Ciencias de la Salud (University Foundation of Health Sciences), FUCS, Colombia
| | - Carlos Gubbay
- San José Hospital, Fundación Universitaria de Ciencias de la Salud (University Foundation of Health Sciences), FUCS, Colombia
| | - Juan Fernando Castañeda
- San José Hospital, Fundación Universitaria de Ciencias de la Salud (University Foundation of Health Sciences), FUCS, Colombia
| | - Álvaro Granados
- San Jose Hospital, Professor at Fundación Universitaria de Ciencias de la Salud (University Foundation of Health Sciences), Colombia
| |
Collapse
|
25
|
Djulbegovic MB, Uversky VN, Harbour JW, Galor A, Karp CL. Structural Protein Analysis of Driver Gene Mutations in Conjunctival Melanoma. Genes (Basel) 2021; 12:genes12101625. [PMID: 34681018 PMCID: PMC8535873 DOI: 10.3390/genes12101625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/05/2021] [Accepted: 10/12/2021] [Indexed: 12/15/2022] Open
Abstract
In recent years, there has been tremendous enthusiasm with respect to detailing the genetic basis of many neoplasms, including conjunctival melanoma (CM). We aim to analyze five proteins associated with CM, namely BRAF, NRAS, c-KIT, NF1, and PTEN. We evaluated each protein for its intrinsically disordered protein regions (IDPRs) and its protein-protein interactions (PPI) with the Predictor of Natural Disordered Protein Regions (PONDR®) and the Search Tool for the Retrieval of Interacting Genes (STRING®). Our PONDR® analysis found high levels of IDPRs in all five proteins with mutations linked to CM. The highest levels of IDPRs were in BRAF (45.95%), followed by PTEN (31.76%), NF1 (22.19%), c-KIT (21.82%), and NRAS (14.81%). Our STRING analysis found that each of these five proteins had more predicted interactions then expected (p-value < 1.0 × 10−16). Our analysis demonstrates that the mutations linked to CM likely affected IDPRs and possibly altered their highly complex PPIs. Quantifying IDPRs in BRAF, NRAS, c-KIT, NF1, and PTEN and understanding these protein regions are important processes as IDPRs can be possible drug targets for novel targeted therapies for treating CM.
Collapse
Affiliation(s)
- Mak B. Djulbegovic
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (M.B.D.); (J.W.H.); (A.G.)
| | - Vladimir N. Uversky
- Department of Molecular Medicine and USF Health Byrd Alzheimer’s Research Institute, Morsani College of Medicine, University of South Florida, Bruce B. Downs Blvd., MDC07, Tampa, FL 33612, USA;
- Center for Molecular Mechanisms of Aging and Age-Related Diseases, Moscow Institute of Physics and Technology, Institutskiy Pereulok, 9, Dolgoprudny, 141700 Moscow, Russia
| | - J. William Harbour
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (M.B.D.); (J.W.H.); (A.G.)
| | - Anat Galor
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (M.B.D.); (J.W.H.); (A.G.)
- Ophthalmology, Miami Veterans Affairs Medical Center, Miami, FL 33136, USA
- Research Services, Miami Veterans Affairs Medical Center, Miami, FL 33136, USA
| | - Carol L. Karp
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (M.B.D.); (J.W.H.); (A.G.)
- Correspondence: ; Tel.: +1-305-326-6165
| |
Collapse
|
26
|
Lee JH, Woo SS, Shin SH, Kim HJ, Kim JH, Kim SH, Suh IS. Upper eyelid reconstruction using a combination of a nasal septal chondromucosal graft and a Fricke flap: a case report. Arch Craniofac Surg 2021; 22:204-208. [PMID: 34474544 PMCID: PMC8413922 DOI: 10.7181/acfs.2021.00262] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/17/2021] [Indexed: 12/03/2022] Open
Abstract
Sebaceous carcinoma is a malignant neoplasm that usually arises in the sebaceous glands of the eyelids. Its pathogenesis is unknown; however, irradiation history, immunosuppression, and use of diuretics are known risk factors. The mainstay of treatment for sebaceous carcinoma of the eyelid is wide surgical resection with a safety margin of 5 to 6 mm, which often results in full-thickness defects. The reconstruction of a full-thickness defect of the eyelid should be approached using a three-lamella method: a mucosal component replacing the conjunctiva, a cartilage component for the tarsal plate, and a flap or skin graft for the skin of the eyelid. In this case, a fullthickness defect of the upper eyelid was reconstructed after tumor removal using a combination of a nasal septum chondromucosal composite graft and a forehead transposition flap, also known as a “Fricke flap.” The flap was designed to include a line of the eyebrow on the lower margin of the flap to replace the eyelash removed during tumor excision. The wound healed completely, without any early or late complications, and the outcome was satisfactory.
Collapse
Affiliation(s)
- Ju Ho Lee
- Department of Plastic and Reconstructive Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Sang Seok Woo
- Department of Plastic and Reconstructive Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Se Ho Shin
- Department of Plastic and Reconstructive Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Hyeon Jo Kim
- Department of Plastic and Reconstructive Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Jae Hyun Kim
- Department of Plastic and Reconstructive Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Seong Hwan Kim
- Department of Plastic and Reconstructive Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - In Suck Suh
- Department of Plastic and Reconstructive Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| |
Collapse
|
27
|
Hayashi D, Kusutani N, Sowa-Osako J, Kamo R, Hayashi E, Ohsawa M, Goto K, Tsuruta D. Combined Merkel cell carcinoma and sebaceous carcinoma in the eyelid with cervical lymph node metastasis of both components. J Dermatol 2021; 48:e175-e177. [PMID: 33533503 DOI: 10.1111/1346-8138.15780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/17/2021] [Accepted: 01/18/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Daisuke Hayashi
- Department of Dermatology, Osaka City University Graduate School of Medicine Osaka, Osaka, Japan
| | - Nao Kusutani
- Department of Dermatology, Osaka City University Graduate School of Medicine Osaka, Osaka, Japan.,Department of Dermatology, Osaka City General Hospital, Osaka, Japan
| | - Junko Sowa-Osako
- Department of Dermatology, Osaka City University Graduate School of Medicine Osaka, Osaka, Japan
| | - Riei Kamo
- Department of Dermatology, Osaka City University Graduate School of Medicine Osaka, Osaka, Japan.,Department of Dermatology, Kashibaseiki Hospital, Kashiba, Japan
| | - Eriko Hayashi
- Department of Dermatology, Osaka City University Graduate School of Medicine Osaka, Osaka, Japan
| | - Masahiko Ohsawa
- Department of Diagnostic Pathology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Keisuke Goto
- Department of Pathology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan.,Department of Pathology, Itabashi Central Clinical Laboratory, Tokyo, Japan.,Department of Diagnostic Pathology, Shizuoka Cancer Center Hospital, Sunto, Japan.,Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka, Japan.,Department of Dermatology, Hyogo Cancer Center, Akashi, Japan
| | - Daisuke Tsuruta
- Department of Dermatology, Osaka City University Graduate School of Medicine Osaka, Osaka, Japan
| |
Collapse
|
28
|
Walsh N. Merkel cell carcinoma of the eyelid and periocular region: A review. Saudi J Ophthalmol 2021; 35:186-192. [PMID: 35601863 PMCID: PMC9116095 DOI: 10.4103/sjopt.sjopt_55_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 03/17/2021] [Accepted: 04/22/2021] [Indexed: 11/08/2022] Open
Abstract
Merkel cell carcinoma (MCC) is a rare primary cutaneous neuroendocrine carcinoma with a high mortality rate. It typically affects elderly Caucasians, with a slight predilection for males. It is associated with chronic sun exposure and/or immunosuppression. Almost half of all cases occur on the head or neck and an estimated 2.5%–10% arise on the eyelids or periocular skin. It ranks as the 5th most common malignant tumor at these sites, preceded in frequency by basal cell, squamous cell and sebaceous carcinoma, as well as melanoma. Its clinical presentation as a violaceous nodule/plaque lacks specificity, and it can be mistaken for cysts, chalazia or basal cell carcinomas. Sub-specialized histopathological and immunohistochemical evaluations are required for diagnosis. Clinical staging defines the extent of disease and governs management. This includes surgery and adjuvant radiotherapy for localized tumors and of late, immunotherapy for metastatic disease. Significant advances in our understanding of the dual etiopathogenesis (Merkel cell polyomavirus- and Ultraviolet radiation-induced) and the biology of the neoplasm have been achieved in recent years. Issuing from the tumor's known susceptibility to host immunity, a recent therapeutic breakthrough has occurred whereby immune checkpoint inhibition has been shown to mitigate advanced disease. These factors and the increased global incidence of the tumor have brought it to the forefront of medical attention. This review provides a clinically relevant update on MCC, with special reference to cases arising on the eyelid/periocular region.
Collapse
|
29
|
Huang J, Schaefer J, Wang Y, Gioia L, Pei Y, Shi X, Waris S, Zhao C, Nguyen J, Du J. Metabolic signature of eyelid basal cell carcinoma. Exp Eye Res 2020; 198:108140. [PMID: 32649951 DOI: 10.1016/j.exer.2020.108140] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/21/2020] [Accepted: 07/02/2020] [Indexed: 12/29/2022]
Abstract
PURPOSE Eyelid basal cell carcinoma (BCC) is the most common eyelid malignancy. Metabolic reprogramming is critical in tumorigenesis, but the metabolic feature of eyelid BCC remains elusive. In this study, we aim to reveal the metabolic profile in eyelid BCC using targeted metabolomics. Eyelid samples were collected from patients who had removal of BCC and from control patients who underwent blepharoplasty. Multivariate analysis of metabolomics data distinguished the two groups, indicating that eyelid BCC has significantly different metabolome than the healthy tissue. We found 16 increased and 11 decreased metabolites in the BCC tissues. These metabolites were highly enriched in the metabolism of nicotinamide adenine dinucleotide (NAD), glutathione metabolism, polyamine metabolism, and the metabolism of glycine, serine, threonine, arginine and proline. amino acid metabolism. Metabolites from NAD metabolism (Nicotinamide; Nicotinamide riboside; N1-Methylnicotinamide) had the highest sensitivity, specificity, and prediction accuracy in a prediction model for eyelid BCC. In conclusion, eyelid BCC has a signature change of cell metabolome. Metabolites in NAD metabolic pathways could potentially be biomarkers or therapeutic targets for eyelid BCC.
Collapse
Affiliation(s)
- Jiancheng Huang
- Eye Institute, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, 200031, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, 200031, China; Department of Ophthalmology, West Virginia University, Morgantown, WV, 26506, USA; Department of Biochemistry, West Virginia University, Morgantown, WV, 26506, USA
| | - Jamie Schaefer
- Department of Ophthalmology, West Virginia University, Morgantown, WV, 26506, USA
| | - Yekai Wang
- Department of Ophthalmology, West Virginia University, Morgantown, WV, 26506, USA; Department of Biochemistry, West Virginia University, Morgantown, WV, 26506, USA
| | - Lauren Gioia
- Department of Ophthalmology, West Virginia University, Morgantown, WV, 26506, USA
| | - Ying Pei
- Department of Industrial and Management System Engineering, West Virginia University, Morgantown, WV, 26506, USA
| | - Xiaofei Shi
- Department of Industrial and Management System Engineering, West Virginia University, Morgantown, WV, 26506, USA
| | - Shanawar Waris
- Department of Ophthalmology, West Virginia University, Morgantown, WV, 26506, USA
| | - Chen Zhao
- Eye Institute, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, 200031, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, 200031, China
| | - John Nguyen
- Department of Ophthalmology, West Virginia University, Morgantown, WV, 26506, USA; Department of Otolaryngology, West Virginia University, Morgantown, WV, 26506, USA.
| | - Jianhai Du
- Department of Ophthalmology, West Virginia University, Morgantown, WV, 26506, USA; Department of Biochemistry, West Virginia University, Morgantown, WV, 26506, USA.
| |
Collapse
|
30
|
Savino G, Volpe G, Grimaldi G, Battendieri R, Midena G, Lanni V, Bernardo R, Iuliano A. Relation of the eighth edition of the American Joint Committee on Cancer staging system with histological risk classification for primary eyelid basal cell carcinoma. Eur J Ophthalmol 2020; 31:1399-1404. [PMID: 32418449 DOI: 10.1177/1120672120922455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To investigate the relation between the eighth edition of the American Joint Committee on Cancer staging system and histological risk classification for primary eyelid basal cell carcinoma. METHODS Retrospective, observational case series of patients undergoing excisional biopsy for primary eyelid basal cell carcinoma in two tertiary centres between 2008 and 2018. Patients with <6 months of follow-up were excluded. Outcomes measured included histological subtype, American Joint Committee on Cancer 7 and 8 staging. RESULTS A total of 222 cases were included over a 10-year period, with a mean (range) follow-up of 25.74 (6-120) months and a median (range) age of 70 (28-93) years. According to American Joint Committee on Cancer 8, the most common T category was T1a (64%), followed by T1b (18%) and T2a (8%). Of the 222 specimens, 183 (82.43%), 17 (7.66%), 19 (8.56%) and 3 (1.35%) were staged as IA, IB, IIA and IIB, respectively. The most common histological subtype was nodular in IA category and infiltrative in categories IB and IIA. Histologically, low-risk basal cell carcinomas were related to lower American Joint Committee on Cancer staging (IA), whereas high-risk basal cell carcinomas were related to American Joint Committee on Cancer stages IB and IIA (p < 0.001). No significant relation was found between T categorisation and risk stratification when adopting American Joint Committee on Cancer 7. CONCLUSION American Joint Committee on Cancer 8 staging system is strongly related to primary eyelid basal cell carcinoma histological risk classification.
Collapse
Affiliation(s)
- Gustavo Savino
- UOC Oncologia Oculare, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giulio Volpe
- Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Remo Battendieri
- UOC Oncologia Oculare, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | | | - Vittoria Lanni
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Roberta Bernardo
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Adriana Iuliano
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| |
Collapse
|
31
|
UZLU D, AKYOL N, ERCİN ME, TÜRK A, İMAMOĞLU Hİ. Kliniğimizde Cerrahi Olarak Tedavi Edilen Göz Kapağı Tümörlerinin Histopatolojik Bulguları. DICLE MEDICAL JOURNAL 2020. [DOI: 10.5798/dicletip.706116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
32
|
Leivo T, Sarmela J, Enckell-Aaltonen M, Dafgård Kopp E, Schmitt C, Toft PB, Sigurdsson H, Uusitalo M. Nordic treatment practices survey and consensus for treatment of eyelid sebaceous carcinoma. BMC Ophthalmol 2020; 20:103. [PMID: 32178641 PMCID: PMC7074984 DOI: 10.1186/s12886-020-01367-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 03/04/2020] [Indexed: 12/03/2022] Open
Abstract
Background The purpose was to describe the Nordic treatment practices and to reach a Nordic consensus for the treatment of sebaceous eyelid carcinoma. Methods The treatment practices data was collected by a questionnaire with 37 questions to the Nordic oculoplastic surgeons and analyzed. A PubMed MEDLINE database search was done to gather data on the published treatment practices and recommendations. A working group that consisted of in minimum one senior consultant from each leading Nordic University Eye Hospital was assigned. A structured interactive method was used to establish the consensus. Results Twenty-four doctors responded to the questionnaire. 23/24 (96%) of the respondents took a biopsy before surgery. Regional lymph node scanning was routinely done by 14/23 (61%) and a systemic screening of a metastatic disease by 13/23 (57%). 6/22 (27%) never took conjunctival mapping biopsies and 12/23 (52%) never screened for Muir- Torre. Respondents used Mohs surgery, frozen section or multi-stage excision with delayed closure, and 5–6 mm was the mostly preferred margin. Sentinel lymph node biopsy was a possible option for 9/22 (41%) and cryotherapy and Mitomycin C for 6/22 (27%) respondents. 50% of respondents considered radiation as a treatment option. 15/16 (94%) respondents always followed-up their patients, most for 5 years. Two thirds scanned regional lymph nodes during the follow-up. Consensus was reached for 18 statements representing three domains: preoperative work-up, treatment and follow-up. Conclusion Treatment practices differ in between the five Nordic countries which have similar public health care systems. In the article the authors present a Nordic consensus for the treatment of eyelid sebaceous carcinoma.
Collapse
Affiliation(s)
- Tiina Leivo
- Department of Ophthalmology, Helsinki University Hospital and University of Helsinki, PO Box 220, FI-00029 HUS, Helsinki, Finland.
| | - Johanna Sarmela
- Department of Ophthalmology, Helsinki University Hospital and University of Helsinki, PO Box 220, FI-00029 HUS, Helsinki, Finland
| | - Maria Enckell-Aaltonen
- Department of Ophthalmology, Helsinki University Hospital and University of Helsinki, PO Box 220, FI-00029 HUS, Helsinki, Finland
| | - Eva Dafgård Kopp
- Department of Ophthalmology, S:t Erik's Eye Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Caroline Schmitt
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
| | - Peter B Toft
- Department of Ophthalmology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Haraldur Sigurdsson
- Department of Ophthalmology, Landspitali, University of Iceland, Reykjavik, Iceland
| | - Marita Uusitalo
- Department of Ophthalmology, Helsinki University Hospital and University of Helsinki, PO Box 220, FI-00029 HUS, Helsinki, Finland
| |
Collapse
|
33
|
Ferreira TA, Pinheiro CF, Saraiva P, Jaarsma-Coes MG, Van Duinen SG, Genders SW, Marinkovic M, Beenakker JWM. MR and CT Imaging of the Normal Eyelid and its Application in Eyelid Tumors. Cancers (Basel) 2020; 12:cancers12030658. [PMID: 32178233 PMCID: PMC7139934 DOI: 10.3390/cancers12030658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 02/15/2020] [Accepted: 02/24/2020] [Indexed: 11/16/2022] Open
Abstract
T-staging of most eyelid malignancies includes the assessment of the integrity of the tarsal plate and orbital septum, which are not clinically accessible. Given the contribution of MRI in the characterization of orbital tumors and establishing their relations to nearby structures, we assessed its value in identifying different eyelid structures in 38 normal eyelids and evaluating tumor extension in three cases of eyelid tumors. As not all patients can receive an MRI, we evaluated those same structures on CT and compared both results. All eyelid structures were identified on MRI and CT, except for the conjunctiva on both techniques and for the tarsal muscles on CT. Histopathology confirmed the MRI findings of orbital septum invasion in one patient, and the MRI findings of intact tarsus and orbital septum in another patient. Histopathology could not confirm or exclude tarsal invasion seen on MRI on two patients. Although imaging the eyelid is challenging, the identification of most eyelid structures is possible with MRI and, to a lesser extent, with CT and can, therefore, have an important contribution to the T-staging of eyelid tumors, which may improve treatment planning and outcome.
Collapse
Affiliation(s)
- Teresa A. Ferreira
- Department of Radiology, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, The Netherlands; (M.G.J.-C.); (J.-W.M.B.)
- Correspondence:
| | - Carolina F. Pinheiro
- Department of Neuroradiology, Centro Hospitalar e Universitario de Lisboa Central, Rua Jose Antonio Serrano, 1150-199 Lisboa, Portugal;
| | - Paulo Saraiva
- Department of Radiology, Hospital da Luz, Estrada Nacional 10, km 37, 2900-722 Setubal, Portugal;
| | - Myriam G. Jaarsma-Coes
- Department of Radiology, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, The Netherlands; (M.G.J.-C.); (J.-W.M.B.)
- Department of Ophthalmology, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, The Netherlands; (S.W.G.); (M.M.)
| | - Sjoerd G. Van Duinen
- Department of Pathology, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, The Netherlands;
| | - Stijn W. Genders
- Department of Ophthalmology, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, The Netherlands; (S.W.G.); (M.M.)
| | - Marina Marinkovic
- Department of Ophthalmology, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, The Netherlands; (S.W.G.); (M.M.)
| | - Jan-Willem M. Beenakker
- Department of Radiology, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, The Netherlands; (M.G.J.-C.); (J.-W.M.B.)
- Department of Ophthalmology, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, The Netherlands; (S.W.G.); (M.M.)
| |
Collapse
|
34
|
Kalemaki MS, Karantanas AH, Exarchos D, Detorakis ET, Zoras O, Marias K, Millo C, Bagci U, Pallikaris I, Stratis A, Karatzanis I, Perisinakis K, Koutentakis P, Kontadakis GA, Spandidos DA, Tsatsakis A, Papadakis GZ. PET/CT and PET/MRI in ophthalmic oncology (Review). Int J Oncol 2020; 56:417-429. [PMID: 31939615 PMCID: PMC6959466 DOI: 10.3892/ijo.2020.4955] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 12/31/2019] [Indexed: 12/16/2022] Open
Abstract
Orbital and ocular anatomy is quite complex, consisting of several tissues, which can give rise to both benign and malignant tumors, while several primary neoplasms can metastasize to the orbital and ocular space. Early detection, accurate staging and re-staging, efficient monitoring of treatment response, non-invasive differentiation between benign and malignant lesions, and accurate planning of external radiation treatment, are of utmost importance for the optimal and individualized management of ophthalmic oncology patients. Addressing these challenges requires the employment of several diagnostic imaging techniques, such as high-definition digital fundus photography, ultrasound imaging, optical coherence tomography, optical coherence tomography (OCT)-angiography, computed tomography (CT) and magnetic resonance imaging (MRI). In recent years, technological advances have enabled the development of hybrid positron emission tomography (PET)/CT and PET/MRI systems, setting new standards in cancer diagnosis and treatment. The capability of simultaneously targeting several cancer-related biochemical procedures using positron emitting-radiopharmaceuticals, while morphologically characterizing lesions by CT or MRI, together with the intrinsic quantitative capabilities of PET-imaging, provide incremental diagnostic information, enabling accurate, highly efficient and personalized treatment strategies. Aim of the current review is to discuss the current applications of hybrid PET/CT and PET/MRI imaging in the management of patients presenting with the most commonly encountered orbital and ocular tumors.
Collapse
Affiliation(s)
- Maria S Kalemaki
- Department of Ophthalmology, Venizeleio General Hospital of Heraklion, 71409 Heraklion, Greece
| | | | - Dimitris Exarchos
- Department of CT‑MRI and PET/CT, Evangelismos Hospital, 10676 Athens, Greece
| | - Efstathios T Detorakis
- Department of Ophthalmology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Odysseas Zoras
- Department of Surgical Oncology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Kostas Marias
- Foundation for Research and Technology Hellas (FORTH), Computational Biomedicine Laboratory (CBML), 70013 Heraklion, Greece
| | - Corina Millo
- Positron Emission Tomography Department, Clinical Center (CC), National Institutes of Health (NIH), Bethesda, MD 20814, USA
| | - Ulas Bagci
- Center for Research in Computer Vision (CRCV), University of Central Florida (UCF), Orlando, FL 32816, USA
| | - Ioannis Pallikaris
- Department of Ophthalmology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Andreas Stratis
- Foundation for Research and Technology Hellas (FORTH), Computational Biomedicine Laboratory (CBML), 70013 Heraklion, Greece
| | - Ioannis Karatzanis
- Foundation for Research and Technology Hellas (FORTH), Computational Biomedicine Laboratory (CBML), 70013 Heraklion, Greece
| | - Kostas Perisinakis
- Department of Medical Physics, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Pavlos Koutentakis
- Department of Ophthalmology, Venizeleio General Hospital of Heraklion, 71409 Heraklion, Greece
| | - Georgios A Kontadakis
- Department of Ophthalmology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Demetrios A Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Aristidis Tsatsakis
- Laboratory of Forensic Sciences and Toxicology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Georgios Z Papadakis
- Department of Radiology, Medical School, University of Crete, 71003 Heraklion, Greece
| |
Collapse
|
35
|
Impact of Food and Drug Administration Approval of Vismodegib on Prevalence of Orbital Exenteration as a Necessary Surgical Treatment for Locally Advanced Periocular Basal Cell Carcinoma. Ophthalmic Plast Reconstr Surg 2019; 35:350-353. [PMID: 30365473 DOI: 10.1097/iop.0000000000001251] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE To test the hypothesis that the US Food and Drug Administration approval of vismodegib in early 2012 has reduced the prevalence of orbital exenteration for locally advanced periocular basal cell carcinoma (BCC). METHODS Following institutional review board approval, the authors reviewed clinical and pathological data of patients with locally advanced periocular BCC (T4 per the eyelid carcinoma classification in the 8th edition of the AJCC Cancer Staging Manual) treated by the senior author during 2006-2018. Patients were grouped into those who were treated before February 2012 ("before vismodegib approval") and those who presented later ("after vismodegib approval"). RESULTS Forty-two patients with locally advanced periocular BCC were treated during the study period, of whom 31 were men. The median age at presentation was 66 years (range, 43-90). Twenty-two patients had T4a and 20 had T4b tumors. Thirteen patients were treated before and 29 were treated after vismodegib approval. The 2 groups did not differ in age distribution (p = 0.164), sex distribution (p = 0.270), prevalence of recurrent tumor at presentation (p = 0.317), or duration of treatment with vismodegib (p = 0.605). Orbital exenteration was significantly more prevalent in patients treated before vismodegib approval than after (46% vs. 10%, p = 0.016), and vismodegib treatment was significantly more prevalent in patients treated after vismodegib approval than before (when vismodegib was given in clinical trials; 69% vs. 23%, p = 0.008). There was a trend toward more patients retaining their eyes at last follow-up in patients treated after vismodegib approval (83% vs. 54%, p = 0.066). CONCLUSIONS The prevalence of orbital exenteration as a necessary surgical procedure in patients with a locally advanced periocular BCC has fallen since the Food and Drug Administration approval of vismodegib. Although vismodegib is not specifically approved for organ-sparing, it has changed the authors' practice and enabled eye preservation in patients with locally advanced periocular BCC, who would otherwise require an orbital exenteration.
Collapse
|
36
|
Mould-based surface high-dose-rate brachytherapy for eyelid carcinoma. J Contemp Brachytherapy 2019; 11:443-448. [PMID: 31749853 PMCID: PMC6854866 DOI: 10.5114/jcb.2019.88619] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 09/16/2019] [Indexed: 11/17/2022] Open
Abstract
Purpose To evaluate toxicity and clinical outcomes in patients with eyelid tumour treated with contact high-dose-rate brachytherapy (HDR-BT). Material and methods Between April 2010 and August 2017, 10 consecutive patients with tumour of the eyelid underwent contact HDR-BT and custom-made surface mould. Every applicator was manually built using conventional thermoplastic material and standard plastic catheters. The median dose prescribed was 42 Gy (range, 30-48) with a median dose per fraction of 3.5 Gy (range, 2-4.5). The dose was delivered in a median of 12 fractions (range, 10-17) over a median of 16 days. In all cases, an ocular shield was placed to reduce the dose to the eye. Acute and late toxicity was evaluated according to RTOG toxicity criteria. Results We analyzed data of 9 of 10 patients (one patient was excluded because he did not give consent for investigation). The median age was 68 years (range, 31-88). According to the TNM-UICC staging system, 4, 1 and 4 patients were stage IA, IB and IC, respectively. Basal cell and sebaceous gland carcinomas were reported in 5 and 2 patients, respectively; other histological types were non-Hodgkin lymphoma and plasmacytoma. After a median follow-up of 51 months (range, 16-90), there was no evidence of local or distant recurrence. The treatment was very well tolerated. Most commonly acute reactions consisted of low grade (G1-G2) conjunctivitis and skin erythema. Only one patient required a temporary interruption of the treatment due to acute G2 conjunctivitis and G3 lid erythema. Only one G2 late toxicity was reported (corneal ulceration), without resulting in functional impairment or blindness. Conclusions Our results suggest that contact HDR-BT with a customized applicator is safe, effective and offers very good local control and can be considered for the treatment of eyelid tumours.
Collapse
|
37
|
Nagarajan P, El-Hadad C, Gruschkus SK, Ning J, Hudgens CW, Sagiv O, Gross N, Tetzlaff MT, Esmaeli B. PD-L1/PD1 Expression, Composition of Tumor-Associated Immune Infiltrate, and HPV Status in Conjunctival Squamous Cell Carcinoma. Invest Ophthalmol Vis Sci 2019; 60:2388-2398. [PMID: 31141610 PMCID: PMC6890426 DOI: 10.1167/iovs.19-26894] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose Conjunctival squamous cell carcinoma (SCC), a type of ocular surface neoplasia, is primarily treated by surgical resection and topical immuno- or chemotherapy. Metastatic disease may be treated with systemic chemo- or immunotherapy, albeit with variable response. The purpose of this study was to determine whether immune checkpoint blockade might be considered in the management of conjunctival SCC. Methods In this retrospective study, we evaluated tumor programmed death-ligand 1 (PD-L1) expression, high-risk human papillomavirus (HPV) status, and immunohistochemical expression of cluster of differentiation 3 (CD3), cluster of differentiation 8 (CD8), and programmed death 1 (PD1) in tumor-associated immune infiltrate in a series of 31 conjunctival SCCs. Results PD-L1 expression in ≥1% of tumor cells was noted in 14 conjunctival SCCs (47%) and was more prevalent in invasive than in situ SCC and among tumors with higher American Joint Committee on Cancer (AJCC) T category (≥T3 versus ≤T2). The density of CD3-positive T cells was higher in primary than recurrent tumors and higher in invasive than in situ tumors. Density of CD3-positive and CD8-positive T cells was higher in higher AJCC stage tumors. Density of CD8-positive T cells was higher in HPV-positive than HPV-negative tumors. PD-L1 expression correlated with a higher density of CD3-, CD8-, and PD1-positive cells in the tumor-associated immune infiltrate but not with HPV status. Conclusions Our findings demonstrate that PD-L1 is expressed in almost half of conjunctival SCCs. The density of tumor-associated immune cells correlated with invasive SCC, stage, and HPV status in conjunctival SCC. Our findings support further studies to establish the potential application of immune checkpoint blockade in the management of conjunctival SCC.
Collapse
Affiliation(s)
- Priyadharsini Nagarajan
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States
| | - Christian El-Hadad
- Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States
| | - Stephen K Gruschkus
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States
| | - Jing Ning
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States
| | - Courtney W Hudgens
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States
| | - Oded Sagiv
- Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States
| | - Neil Gross
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States
| | - Michael T Tetzlaff
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States.,Department of Translational and Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States
| | - Bita Esmaeli
- Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States
| |
Collapse
|
38
|
Ci C, Wu C, Lyu D, Chang X, He C, Liu W, Chen L, Ding W. Downregulation of kynureninase restrains cutaneous squamous cell carcinoma proliferation and represses the PI3K/AKT pathway. Clin Exp Dermatol 2019; 45:194-201. [PMID: 31419330 DOI: 10.1111/ced.14072] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND The protein kynureninase (KYNU) has recently been reported to participate in the pathological processes of various diseases. AIM To explore the expression and the biological function of KYNU in cutaneous squamous cell carcinoma (cSCC). METHODS Expression of KYNU in cSCC cell lines and tissues was firstly evaluated based on the Gene Expression Omnibus and the Oncomine databases. Quantitative reverse transcription-PCR was performed to determine the mRNA expression of KYNU in cSCC cell lines. Small interfering RNA (siRNA) was used for silencing KYNU. The effect of KYNU on the growth and motility of cSCC cells was determined by cell counting kit-8, wound-healing and Transwell assays, and western blotting was used to determine the protein expression of KYNU, AKT, phosphoinositide 3-kinase (PI3K), phosphorylated (p)-AKT and p-PI3K. RESULTS KYNU was significantly upregulated in cSCC tissues and cell lines. Knockdown of KYNU using siRNA noticeably suppressed the proliferation, migration and invasion ability of SCL-1 cells (P < 0.01). Western blotting revealed that phosphorylation of AKT and PI3K was markedly inhibited after silencing KYNU. The ratios of p-AKT/AKT and p-PI3K/PI3K were significantly decreased in the si-KYNU group compared with the control group. CONCLUSION Depletion of KYNU could inhibit the growth of cSCC cells, possibly through modulating PI3K/AKT pathway. These data indicate that KYNU takes a key part in the malignant progression of cSCC, and could be considered as a promising therapeutic target for cSCC treatment.
Collapse
Affiliation(s)
- C Ci
- Department of, Dermatology, First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - C Wu
- Department of, Dermatology, First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - D Lyu
- Department of, Burn and Plastic Surgery, First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - X Chang
- Department of, Dermatology, First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - C He
- Department of, Dermatology, First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - W Liu
- Department of, Dermatology, First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - L Chen
- Department of, Burn and Plastic Surgery, First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - W Ding
- Department of, Burn and Plastic Surgery, First Affiliated Hospital of Wannan Medical College, Wuhu, China
| |
Collapse
|
39
|
Li X, Tan L, Kou H, Zhang J, Wang Y, Li G, Lu Y. Ocular preservation through limited tumor excision combined with ALA-PDT in patients with periocular basal cell carcinoma. Photodiagnosis Photodyn Ther 2019; 27:291-294. [DOI: 10.1016/j.pdpdt.2019.06.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 06/18/2019] [Accepted: 06/20/2019] [Indexed: 02/01/2023]
|
40
|
Santoni A, Thariat J, Maschi C, Herault J, Baillif S, Lassalle S, Peyrichon ML, Salleron J, Caujolle JP. Management of Invasive Squamous Cell Carcinomas of the Conjunctiva. Am J Ophthalmol 2019; 200:1-9. [PMID: 30552889 DOI: 10.1016/j.ajo.2018.11.024] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 11/28/2018] [Accepted: 11/30/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE Ocular surface squamous neoplasia includes a spectrum of diseases from dysplasia to invasive squamous cell carcinoma (SCC) of the conjunctiva. Whether the degree of invasion influences outcomes is debated. We evaluated the outcomes and management of conjunctival carcinomas defined as ≤0.2 mm invasion of the chorion (microinvasive; miSCC) or over (SCC). DESIGN Retrospective case series. METHODS Clinical, tumor, and therapeutic characteristics and outcomes were collected for consecutive patients with histology-proven invasive conjunctival miSCC/SCC treated between 2002 and 2017. RESULTS Patients were 70% men, ≥70 years old (56%), with carcinomas of the bulbar conjunctiva (83.0%). Limbal, corneal, and/or scleral involvement were present in 70.4%, 42.6%, and 27.8%, respectively. Patient characteristics, tumor characteristics, and no-touch surgery rates were similar between the 39 SCC and 15 miSCC. However, mitomycin was performed in 93.3% and 20.5% of miSCC and SCC, respectively (P < .001). Proton therapy was performed in 0% and 92.0% of miSCC and SCC, respectively (P < .001). SCC received mitomycin in case of tumoral resection margins, respectively (P = .018). The 24-month incidence of local relapse was 14.8%, including 20% and 12% for miSCC and SCC, respectively (P = .079). Irradiation was the only prognostic factor associated with a lower risk for local relapse (hazard ratio [0.25]; P = .045). There were 2 cancer-related deaths (2%). Mild/moderate anterior segment complications occurred in one third of the patients. CONCLUSIONS miSCC had slightly worse relapse rates compared with SCC. Postoperative proton therapy, performed in SCC only, was associated with a lower risk for relapse.
Collapse
Affiliation(s)
- Alexandra Santoni
- Department of Ophthalmology, Pasteur 2 Teaching Hospital, Nice, France
| | - Juliette Thariat
- Department of Radiation Oncology, Francois Baclesse Cancer ARCHADE Center, Normandie Universite-Unicaen, Caen, France.
| | - Célia Maschi
- Department of Ophthalmology, Pasteur 2 Teaching Hospital, Nice, France
| | - Joel Herault
- Department of Radiation Oncology, Antoine-Lacassagne Cancer Center, Nice, France
| | - Stéphanie Baillif
- Department of Ophthalmology, Pasteur 2 Teaching Hospital, Nice, France
| | - Sandra Lassalle
- Department of Biopathology, Pasteur 2 Teaching Hospital, Nice, France
| | | | - Julia Salleron
- Department of Biostatistics, Institut de Cancérologie de Lorraine, Université de Lorraine, Vandœuvre-lès-Nancy, France
| | | |
Collapse
|
41
|
Chalkia AK, Bontzos G, Spandidos DA, Detorakis ET. Human papillomavirus infection and ocular surface disease (Review). Int J Oncol 2019; 54:1503-1510. [PMID: 30896784 PMCID: PMC6438422 DOI: 10.3892/ijo.2019.4755] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 03/15/2019] [Indexed: 11/14/2022] Open
Abstract
Human papillomavirus (HPV) infection has been implicated as a primary cause of lesions in the anogenital region, skin, oropharynx and respiratory tract. Additionally, the role of HPV in the pathogenesis of ocular surface disease has also been extensively studied. Conjunctival papilloma development has been strongly associated with the HPV infection of certain subtypes. On the other hand, the role of HPV in conjunctival pterygium, conjunctival intraepithelial neoplasia (CIN) and ocular surface squamous neoplasia (OSSN) remains controversial. Genetic predisposition and environmental factor is important in HPV hosts as regards the pathogenesis of ocular surface disease. Several studies have indicate a synergic role of HPV with ultraviolet radiation in pterygium establishment. A higher recurrence risk rate and more aggressive disease of ophthalmic pterygium is observed in cases of HPV infection. The purpose of this review was to provide a systematic review of the literature and to assist in a better understanding of the role of HPV in ocular surface disease.
Collapse
Affiliation(s)
- Aikaterini K Chalkia
- Department of Ophthalmology, University Hospital of Heraklion, 71110 Heraklion, Greece
| | - Georgios Bontzos
- Department of Ophthalmology, Red Cross Hospital, 11526 Athens, Greece
| | - Demetrios A Spandidos
- Department of Virology, Medical School, University of Crete, 71110 Heraklion, Greece
| | | |
Collapse
|
42
|
Electrochemotherapy in the treatment of locally advanced or recurrent eyelid-periocular basal cell carcinomas. Sci Rep 2019; 9:4285. [PMID: 30862897 PMCID: PMC6414678 DOI: 10.1038/s41598-019-41026-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 02/25/2019] [Indexed: 12/21/2022] Open
Abstract
There is increasing evidence about the effectiveness of electrochemotherapy (ECT) in the treatment of basal cell carcinomas in the head and neck region, although its role in the management of eyelid-periocular skin tumors has to be clarified. The aim of the present study is to evaluate the results of ECT in the treatment of locally advanced primary and recurrent eyelid-periocular skin basal cell carcinomas. Twelve patients with basal cell carcinoma involving the eyelid-periocular skin region were treated with ECT. Three patients had locally advanced primary tumors, while 9 patients had recurrent tumors. All treatments were performed according to the ESOPE guidelines, using Cliniporator TM device. All patients received bleomycin based ECT. The route of administration was intratumoral in 3 patients and intravenous in 9 patients. Tumor response was evaluated using the RECIST 1.1. criteria. ECT resulted in complete response of the periocular skin tumors in all patients. Lower eyelid ectropion was developed in 3 patients which had to be corrected surgically. ECT can be used effectively in the treatment of locally advanced or recurrent basal cell carcinomas in the eyelid-periocular skin region. Excellent tumor control can be achieved with good functional and cosmetic results without systemic adverse events with short interval follow-up.
Collapse
|
43
|
Weesie F, Naus NC, Vasilic D, Hollestein LM, van den Bos RR, Wakkee M. Recurrence of periocular basal cell carcinoma and squamous cell carcinoma after Mohs micrographic surgery: a retrospective cohort study. Br J Dermatol 2019; 180:1176-1182. [PMID: 30536656 PMCID: PMC6849866 DOI: 10.1111/bjd.17516] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2018] [Indexed: 12/02/2022]
Abstract
Background Despite the widespread use of Mohs micrographic surgery (MMS) for periocular basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) – together called keratinocyte carcinoma (KC) – follow‐up data regarding recurrences are limited. Objectives To investigate the recurrence rate for periocular KCs after MMS and to describe our experience with interdisciplinary collaborations. Methods Patients with periocular KCs treated with MMS between 2006 and 2016 in a tertiary MMS referral hospital were included in this retrospective cohort study. Descriptive statistics were used to describe the MMS procedure‐related characteristics. Using follow‐up data from the electronic patient records and linkage with the Dutch nationwide network and registry of histopathology and cytopathology on 30 June 2017, the recurrence rate was evaluated and calculated using a cumulative incidence curve. Results In total, 683 (93·7%) periocular BCCs and 46 (6·3%) SCCs were treated with MMS. Three‐quarters (n = 549) were primary tumours and the majority were located at the medial canthus or lower eyelid (n = 649, 89·0%). In 505 MMS procedures (69·3%) an oculoplastic surgeon participated, and in 63 patients (8·6%) a plastic surgeon performed the reconstruction. After a median follow‐up of 46 months the recurrence rate was 3·0%, based on 22 recurrences (20 BCCs and two SCCs). Conclusions MMS is an excellent treatment option for periocular KCs, with a low recurrence rate. Due to this specific anatomical location an interdisciplinary approach should pre‐eminently be considered. What's already known about this topic? Mohs micrographic surgery (MMS) is a widespread treatment for periocular basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) because of the expected high cure rate, while preserving healthy tissue. Follow‐up data on the risk of recurrence after periocular MMS are limited.
What does this study add? This retrospective cohort study demonstrates that with a recurrence rate of 3·0% after almost 4 years, MMS has proven to be an excellent surgical treatment option for periocular BCC and SCC. We advise a low threshold for interdisciplinary collaborations, especially in case of recurrent BCCs, BCCs localized in the medial canthus and aggressive BCCs.
Linked Comment: https://doi.org/10.1111/bjd.17736. https://www.bjdonline.com/article/
Collapse
Affiliation(s)
- F Weesie
- Department of Dermatology, Erasmus MC, Dr. Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands
| | - N C Naus
- Department of Ophthalmology, Erasmus MC, Dr. Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands
| | - D Vasilic
- Department of Plastic Surgery, Erasmus MC, Dr. Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands
| | - L M Hollestein
- Department of Dermatology, Erasmus MC, Dr. Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands
| | - R R van den Bos
- Department of Dermatology, Erasmus MC, Dr. Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands
| | - M Wakkee
- Department of Dermatology, Erasmus MC, Dr. Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands
| |
Collapse
|
44
|
Merz LE, Afriyie O, Jiagge E, Adjei E, Foltin SK, Ludwig ML, McHugh JB, Brenner JC, Merajver SD. Clinical characteristics, HIV status, and molecular biomarkers in squamous cell carcinoma of the conjunctiva in Ghana. Health Sci Rep 2019; 2:e108. [PMID: 30809594 PMCID: PMC6375545 DOI: 10.1002/hsr2.108] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 09/02/2018] [Accepted: 11/05/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND AND AIMS Conjunctival squamous cell carcinoma (CSCC) varies in incidence geographically from 0 to 1 case per 100 000 per year globally. Additionally, the incidence of CSCC is known to increase 49% for every 10° decrease in latitude. Since the onset of the AIDS epidemic, there has been a trend of increasing incidence of CSCC in Africa, and despite relatively stable levels of ultraviolet (UV) exposure, there is an observed 12 times greater risk of developing CSCC when individuals are infected with HIV. In this study, we aim to analyze the clinical characteristics and biomarkers of CSCC in Ghana. METHODS In this study, a registry review of patients from January 2011 to May 2016 with CSCC at Komfo-Anokye Teaching Hospital in Kumasi, Ghana, was performed (n = 64). Tumor blocks of the CSCC were analyzed for the expression of various biomarkers. RESULTS In this study, the median age of onset of CSCC is 46.5 years old (range of 20-90 y old). Fifty one and a half percent (n = 33) of the cohort is female. There is a low rate of smoking and alcohol use in our CSCC cohort. Thirty-nine percent (n = 12) of Ghanaian men with CSCC are HIV-, while only 12% (n = 4) of women are HIV-. Fifteen patients had metastasis to lymph nodes or other tissues, and we observed a statistically significant relationship between HIV infection and metastasis (P = 0.027, chi-squared test). We observed no statistically significant relationship between known prognostic CSCC biomarkers and HIV status, age, or tumor stage. CONCLUSION Better characterization of CSCC could have a profound impact on the prevention, early identification, and treatment of CSCC in Africa. A retrospective chart analysis and collection of tumor samples can be challenging in this region due to methods of record keeping and stigma attached to clinical data such as HIV testing and smoking and alcohol use. As a result, in this study, data were often incomplete leading to inconclusive results and analysis that should be interpreted with caution. Future studies should consider a prospective study design that gathers clinical data in a standardized format and ensures fresh tissue from CSCC tumors.
Collapse
Affiliation(s)
- Lauren E. Merz
- University of Michigan Medical SchoolAnn ArborMichiganUSA
| | | | | | | | - Susan K. Foltin
- Department of Otolaryngology—Head and Neck SurgeryMichigan MedicineAnn ArborMichiganUSA
| | - Megan L. Ludwig
- Department of Otolaryngology—Head and Neck SurgeryMichigan MedicineAnn ArborMichiganUSA
- Program in Cellular and Molecular BiologyUniversity of MichiganAnn ArborMichiganUSA
| | | | - J. Chad Brenner
- Department of Otolaryngology—Head and Neck SurgeryMichigan MedicineAnn ArborMichiganUSA
- Program in Cellular and Molecular BiologyUniversity of MichiganAnn ArborMichiganUSA
- Department of Internal Medicine, Rogel Cancer CenterMichigan MedicineAnn ArborMichiganUSA
| | - Sofia D. Merajver
- Department of Internal Medicine, Rogel Cancer CenterMichigan MedicineAnn ArborMichiganUSA
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMichiganUSA
| |
Collapse
|
45
|
|
46
|
van Burink MV, Rakhorst HA, van Couwelaar GM, Schmidbauer U. Postoncological lacrimal duct reconstruction: A practical classification system for reconstructive planning and short-term results of a case series. J Plast Reconstr Aesthet Surg 2018; 71:1796-1803. [PMID: 30213744 DOI: 10.1016/j.bjps.2018.07.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 07/27/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Surgical resection of skin tumors in the medial canthal area may damage the lacrimal duct and can result in chronic epiphora. Postoncologic reconstruction of the lacrimal duct has not been studied extensively. The current study discusses the anatomical and functional features of the lacrimal duct. It describes short-term functional outcomes after monocanalicular reconstruction of the lacrimal duct in a case series of 10 patients. METHODS From February 2015 to October 2017, all patients with a postoncological lacrimal duct defect were analyzed to make an anatomical classification. The functional outcomes of patients after monocanalicular reconstruction were measured with the Munk scale up to 3 months after stent removal. RESULTS Twelve patients had lacrimal duct defects after Mohs resection. Anatomical characteristics were used to create a clinical classification for lacrimal duct defects. This classification divides the upper (U) and lower (L) proximal lacrimal duct into two sections which can be damaged: the punctum and pars verticalis (1), the canaliculus horizontalis (2), or combined (3). The Common lacrimal duct (C) is the distal part of the lacrimal duct and can also be affected. Ten patients were analyzed after lacrimal duct reconstruction. Three months after stent removal, none of the patients suffered from epiphora. CONCLUSIONS This article proposes an anatomical classification for lacrimal duct defects in the proximal lacrimal drainage system. The classification can be applied in comparing cases and determining reconstructive strategies after oncologic skin tumor resection. Short-term results are promising for future efforts to reconstruct the lacrimal duct.
Collapse
Affiliation(s)
- M V van Burink
- Department of Plastic, Reconstructive and Hand Surgery, Ziekenhuisgroep Twente, Geerdinksweg 141, 7555 DL Hengelo, The Netherlands.
| | - H A Rakhorst
- Department of Plastic, Reconstructive and Hand Surgery, Ziekenhuisgroep Twente, Geerdinksweg 141, 7555 DL Hengelo, The Netherlands
| | - G M van Couwelaar
- Department of Plastic, Reconstructive and Hand Surgery, Ziekenhuisgroep Twente, Geerdinksweg 141, 7555 DL Hengelo, The Netherlands
| | - U Schmidbauer
- Department of Plastic, Reconstructive and Hand Surgery, Ziekenhuisgroep Twente, Geerdinksweg 141, 7555 DL Hengelo, The Netherlands.
| |
Collapse
|
47
|
Xu Y, Li F, Jia R, Fan X. Updates on the clinical diagnosis and management of ocular sebaceous carcinoma: a brief review of the literature. Onco Targets Ther 2018; 11:3713-3720. [PMID: 29983580 PMCID: PMC6027821 DOI: 10.2147/ott.s162073] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Ocular sebaceous carcinoma (SC) is an exceedingly rare but aggressive malignancy that can impair patients’ visual acuity or even cause tumor-specific mortality. This tumor usually mimics chronic benign eyelid lesions, thus leading to delayed diagnosis, thereby causing high recurrence and metastasis. Ophthalmologists should be more aware of SC in order to offer correct diagnosis and treatment at the onset of symptoms. Prompt surgical excision with frozen section margin control is the mainstay of SC management after patient evaluation and accurate biopsy. Mohs micrographic surgery has been associated with better tumor control outcomes than wide local excision. Radiation therapy should be considered as adjuvant treatment for locally advanced (stage T3a or higher) or high-risk (pagetoid spread) SC, nodal metastasis, or palliative care. Cryotherapy and topical chemotherapy are used for pagetoid spread. Targeted therapy has an emerging role in more complicated cases. For lymph node and distant metastasis, combination treatments should be provided, including lymph node and neck dissection, radiation therapy, systemic chemotherapy, and even orbital exenteration. The rarity of ocular SC precludes a comprehensive perspective on standard treatment. This paper offers a brief review of recent advances in the clinical diagnosis and management of ocular SC based on current scientific literature.
Collapse
Affiliation(s)
- Yangfan Xu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China, ; .,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, People's Republic of China, ;
| | - Fang Li
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China, ; .,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, People's Republic of China, ;
| | - Renbing Jia
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China, ; .,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, People's Republic of China, ;
| | - Xianqun Fan
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China, ; .,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, People's Republic of China, ;
| |
Collapse
|
48
|
Cicinelli MV, Kaliki S. Ocular sebaceous gland carcinoma: an update of the literature. Int Ophthalmol 2018; 39:1187-1197. [DOI: 10.1007/s10792-018-0925-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Accepted: 04/13/2018] [Indexed: 02/07/2023]
|
49
|
Walters AR, Keck KM, Simmons O, Williams SG, Cross S, Patel RM. Malignant melanoma presenting as amelanotic caruncular lesion in a child. J AAPOS 2017; 21:501-503. [PMID: 29126970 DOI: 10.1016/j.jaapos.2017.06.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 06/15/2017] [Accepted: 06/22/2017] [Indexed: 12/24/2022]
Abstract
Conjunctival melanoma is a rare malignant neoplasm that can present in childhood in any part of the conjunctiva. The infrequency with which conjunctival melanoma is encountered in childhood caruncular lesions makes it a formidable but important aspect of the differential diagnosis. We report the case of a 10-year-old boy who presented with a left caruncular lesion. On histopathologic analysis, the lesion was determined to be BRAF-negative invasive melanoma arising in association with melanocytic nevus. The melanoma was excised using no-touch technique and double freeze thaw cryotherapy. A full systemic work-up revealed no metastasis or abnormality.
Collapse
Affiliation(s)
- Alexander R Walters
- Department of Ophthalmology, Palmetto Health/University of South Carolina, Richland
| | - Katie M Keck
- Department of Ophthalmology, Palmetto Health/University of South Carolina, Richland.
| | - Oliver Simmons
- Department of Otolaryngology, Palmetto Health/University of South Carolina, Richland
| | - Sarah G Williams
- Department of Pathology, Palmetto Health/University of South Carolina, Richland
| | - Stephen Cross
- Department of Ophthalmology, Palmetto Health/University of South Carolina, Richland
| | - Rakesh M Patel
- Department of Ophthalmology, Palmetto Health/University of South Carolina, Richland
| |
Collapse
|
50
|
Bonavolontà P, Dell'Aversana Orabona G, Abbate V, Iaconetta G, Bonavolontà G, Califano L. Treatment of Metastatic Eyelid Carcinoma. J Craniofac Surg 2017; 28:e722-e725. [PMID: 28885435 DOI: 10.1097/scs.0000000000003847] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
PURPOSE The aim of this study was to report management and outcomes in patients affected by eyelids carcinomas involving regional lymph nodes. METHODS We have retrospectively analyzed the data of patients affected by eyelids carcinoma with nodal involvement. The clinical records of 10 patients with malignant eyelid carcinoma and regional nodal metastasis treated between September 2011 and March 2015 have been analyzed. RESULTS The study included 5 women and 5 men (median age 54,5 years; range 37-80 years). The most common tumor was the squamous cell carcinoma (4 cases) followed by sebaceous carcinoma (2 cases): 1 case of epidermoid carcinoma, 1 case of malignant melanoma, 1 case of Merkel carcinoma, and 1 case of basal cell carcinoma. All patients were treated by surgical resection; in 2 cases, orbital exenteration was required. The treatment of regional nodal metastasis consisted of parotidectomy and radical neck dissection followed by radiation therapy. None of the patients developed local recurrence. Three patients died: one, affected by Merkel cell carcinoma, died after 2 months because of metastatic dissemination to the lung; another one, affected by epidermoid carcinoma involving the orbit, died because of liver metastasis; the third one, affected by malignant melanoma, died because of other causes. The follow-up time ranged from 9 to 36 months (median 19.3 months). CONCLUSIONS Patients affected by advanced malignant eyelid carcinoma need to be strictly controlled because metastasis can develop at least 5 years after surgical treatment. Therapy may include a combination of local surgery, neck dissection, and radiation.
Collapse
MESH Headings
- Adenocarcinoma, Sebaceous/mortality
- Adenocarcinoma, Sebaceous/pathology
- Adenocarcinoma, Sebaceous/surgery
- Carcinoma, Basal Cell/mortality
- Carcinoma, Basal Cell/pathology
- Carcinoma, Basal Cell/surgery
- Carcinoma, Squamous Cell/mortality
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/surgery
- Eyelid Neoplasms/mortality
- Eyelid Neoplasms/pathology
- Eyelid Neoplasms/surgery
- Female
- Humans
- Italy/epidemiology
- Lymph Nodes/pathology
- Lymph Nodes/surgery
- Lymphatic Metastasis/pathology
- Male
- Melanoma/mortality
- Melanoma/pathology
- Melanoma/surgery
- Middle Aged
- Neck Dissection/methods
- Neoplasm Recurrence, Local/diagnosis
- Neoplasm Recurrence, Local/mortality
- Neoplasm Recurrence, Local/surgery
- Orbit Evisceration/methods
- Retrospective Studies
- Skin Neoplasms/mortality
- Skin Neoplasms/pathology
- Skin Neoplasms/surgery
- Melanoma, Cutaneous Malignant
Collapse
Affiliation(s)
- Paola Bonavolontà
- *Head and Neck Departement, University of Naples Federico II, Naples †Neurosurgery Departement, University of Salerno, Salerno, Italy
| | | | | | | | | | | |
Collapse
|