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Carlà MM, Sammarco MG, Giannuzzi F, Savino G, Blasi MA, Fionda B, Tagliaferri L, Pagliara MM. Exclusive Ru-106 brachytherapy for the management of a recurrent corneo: Conjunctival squamous cell carcinoma. Brachytherapy 2024; 23:457-462. [PMID: 38556408 DOI: 10.1016/j.brachy.2024.02.002] [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: 07/21/2023] [Revised: 12/18/2023] [Accepted: 02/12/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND We report a case of personalized exclusive brachytherapy treatment for the management of a highly recurrent squamous cell conjunctival carcinoma with corneal invasion. CASE DESCRIPTION This is a case of a Caucasian 81-years-old man who presented 10 years ago to our clinic with a pink-white para-limbal mass with dilated feeder arteries and mild leukoplakia. Excisional biopsy confirmed the presence of conjunctival intraepithelial neoplasia (CIN). Successively, he underwent two 4-weeks cycles of Mytomicin C topical therapy and a second excisional surgery, due to several recurrences of the lesion. At the last relapse, the pink-white peri-limbic mass which invaded the corneal limbus, determining corneal opacification from 5- to 7-clock hours, was confirmed by anterior segment optical coherence tomography (AS-OCT). Due to resistance to MMC therapy and chronic epitheliopathy, an AS-OCT guided exclusive radiotherapy plan was set: a Rhutenium-106 CCD plaque was applied directly over the afflicted corneal surface, the corneal limbus and the neighboring sclera for 24 hours. The remission of both conjunctival and corneal malignancy was complete 2 months after surgery and no signs of recurrence were highlighted at AS-OCT analysis at the 2-year follow up. CONCLUSION Brachytherapy treatment showed optimal management of both corneal and conjunctival involvement, with a free-of-disease follow-up of 24-months. This result suggests that, in specific conditions, Ru-106 brachytherapy could be an effective option of treatment even if not associated with surgical excision.
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Affiliation(s)
- Matteo Mario Carlà
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy; Catholic University "Sacro Cuore", Rome, Italy.
| | - Maria Grazia Sammarco
- Ocular Oncology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy; Catholic University "Sacro Cuore", Rome, Italy
| | - Federico Giannuzzi
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy; Catholic University "Sacro Cuore", Rome, Italy
| | - Gustavo Savino
- Ocular Oncology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy; Catholic University "Sacro Cuore", Rome, Italy
| | - Maria Antonietta Blasi
- Ocular Oncology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy; Catholic University "Sacro Cuore", Rome, Italy
| | - Bruno Fionda
- Catholic University "Sacro Cuore", Rome, Italy; Fondazione Policlinico Universitario A. Gemelli IRCCS, Gemelli ART (Advanced Radiation Therapy) - Interventional Oncology Center (IOC), Rome, Italy
| | - Luca Tagliaferri
- Catholic University "Sacro Cuore", Rome, Italy; Fondazione Policlinico Universitario A. Gemelli IRCCS, Gemelli ART (Advanced Radiation Therapy) - Interventional Oncology Center (IOC), Rome, Italy
| | - Monica Maria Pagliara
- Ocular Oncology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy; Catholic University "Sacro Cuore", Rome, Italy
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Du G, Qiao J, Lei X, Han R. Conjunctival squamous cell carcinoma with massive apoptosis and immune cell infiltration: A case report. Front Surg 2022; 9:1004554. [PMID: 36311937 PMCID: PMC9614080 DOI: 10.3389/fsurg.2022.1004554] [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: 07/27/2022] [Accepted: 09/27/2022] [Indexed: 11/07/2022] Open
Abstract
This case reports a rare case of conjunctival squamous cell carcinoma in China. The elderly (86-year-old) female patient was diagnosed and treated effectively after three times of diagnosis. During this period, she was misdiagnosed and ineffective treatment for many times. Therefore, we propose to make an integrated diagnosis based on histopathological diagnosis, combined with a variety of diagnostic methods including MRI and CDFI, supplemented by updated multiple immunohistochemically techniques, so as to achieve the purpose of accurate diagnosis.
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Affiliation(s)
- Gang Du
- Ophthalmology Department, First Hospital of Lanzhou University, Lanzhou, China
| | - Jun Qiao
- Lanzhou Ophthalmology Center Affiliated to Gansu University of Chinese Medicine, Lanzhou Huaxia Eye Hospital, Lanzhou, China
| | - Xunwen Lei
- Ophthalmology Department, First Hospital of Lanzhou University, Lanzhou, China,Correspondence: Ruiqin Han Xunwen Lei
| | - Ruiqin Han
- State Key Laboratory of Medical Molecular Biology, Department of Biochemistry and Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,Correspondence: Ruiqin Han Xunwen Lei
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Youn GM, Case AG, Jarin T, Li B, Swarup A, Naranjo A, Bou-Khalil C, Yao J, Zhou Q, Hom ME, Rosenthal EL, Wu AY. The Use of Panitumumab-IRDye800CW in a Novel Murine Model for Conjunctival Squamous Cell Carcinoma. Transl Vis Sci Technol 2022; 11:23. [PMID: 35895055 PMCID: PMC9344218 DOI: 10.1167/tvst.11.7.23] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Conjunctival squamous cell carcinoma (SCC) is a sight-threatening ocular surface malignancy with the primary treatment modality being surgical resection. To evaluate surgical imaging modalities to improve surgical resection, we established a novel murine model for conjunctival SCC to demonstrate the utility of panitumumab-IRDye800, a fluorescently labeled anti-epidermal growth factor receptor (EGFR) antibody. Methods NOD-scid IL2Rgammanull (NSG) mice received subconjunctival injection of UM-SCC-1 or SCC-9, head and neck SCC cell lines. On tumor growth, mice were injected with Panitumumab-IRDye800CW, and imaged with a small animal imaging system and optical coherence tomography (OCT). Immunohistochemistry for SCC markers were used to confirm tumor origin. Results Seventy-five percent (N = 4) of the UM-SCC-1 group developed aggressive, rapidly growing tumors that were P40 and EGFR positive within two weeks of inoculation. The SCC-9 tumors failed to demonstrate any growth (N = 4). Ocular tumors demonstrated high fluorescence levels with a tumor to background ratio of 3.8. Conclusions Subconjunctival injections are an appropriate technique to create in vivo models for assessing treatment modalities and novel therapies in conjunctival SCC. Translational Relevance This model demonstrates Panitumumab-IRDye800CW's utility in the ophthalmic setting and suggests that clinical trials may be warranted.
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Affiliation(s)
- Gun Min Youn
- Stanford University School of Medicine, Stanford, CA, USA.,Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, USA
| | - Ayden G Case
- Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, USA.,Trinity College of Arts and Sciences, Duke University, Durham, NC, USA
| | - Trent Jarin
- Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, USA
| | - BaoXiang Li
- Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, USA
| | - Aditi Swarup
- Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, USA
| | - Andrea Naranjo
- Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, USA
| | - Charbel Bou-Khalil
- Stanford University School of Medicine, Stanford, CA, USA.,Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, USA
| | - Jacqueline Yao
- Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, USA
| | - Quan Zhou
- Department of Otolaryngology-Head and Neck Surgery, Stanford Hospital and Clinics, Stanford, CA, USA.,Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Marisa E Hom
- Department of Otolaryngology-Head and Neck Surgery, Stanford Hospital and Clinics, Stanford, CA, USA.,Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Eben L Rosenthal
- Department of Otolaryngology-Head and Neck Surgery, Stanford Hospital and Clinics, Stanford, CA, USA.,Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Albert Y Wu
- Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, USA
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