Excision and cryosurgery in the treatment of conjunctival malignant epithelial tumours

Abstract

Purpose To evaluate the long-term results of combined treatment with excision and cryosurgery for malignant epithelial tumours of the conjunctiva. Methods We retrospectively reviewed the medical records of patients diagnosed with conjunctival malignant epithelial tumours and treated with excision and cryosurgery between 1980 and 1998. The demographic features of the patients, characteristics of the tumours, and the peculiarities of the recurrences were recorded. The SPSS V 9.05 computed program was used for the statistical analysis of the results. Kaplan-Meier plots were used to determine the recurrence-free survival, and the logrank test was used to compare the recurrences according to histological classification. Results A total of 55 subjects (57 eyes), 19 female and 36 male, were included in the study. Their ages ranged between 15 and 82 years (mean 55714 years). Histological diagnosis was conjunctival intraepithelial neoplasia (CIN) in 26 (46%) and invasive squamous cell carcinoma (SCC) of the conjunctiva in 31 eyes (54%). All eyes were treated with excision and cryosurgery with nitrous oxide probe. During the follow-up period of 6 months to 15 years, seven (12.3%) recurrences were observed. The success rate for patients with CIN and invasive SCC was 88.5 and 87.1%, respectively. There was no difference for recurrence rates between CIN and invasive SCC groups according to logrank test (P ¼ 0.68). Conclusions Over the long-term follow-up, cryosurgery following excision is a successful method in the treatment of conjunctival intraepithelial tumours and invasive squamous cell carcinoma of conjunctiva with favourable outcome and minimal complications.

Squamous Cell Carcinoma of the Caruncle

“…Originally described in 1860 by Gascoyan, 8 the term "blue rubber bleb nevus syndrome" was coined by William B. Bean in 1958 9 ; BRBNS is a rare syndrome characterized by distinctive bluish, rubbery, cutaneous venous malformations, varying in size from 0.1 to 50 mm and numbering up to several hundred. These malformations can be partly or completely emptied on compression and refill slowly.…”

“…Tumors of the conjunctiva grow in all directions, resembling tree roots. 8 Therefore, simple surgical excision, even with wide margins, could miss small root tips at the edge and/or base of the scleral bed. Hence, surgical excision combined with cryotherapy or adjuvant chemotherapy (MMC, 5-FU, topical interferon, and ranibizumab) is recommended and has been reported to reduce recurrence rate in OSSN.…”

Corneal Topographic Changes in a Case of Limbal Conjunctival Carcinoma

“…Cryotherapy was applied on the conjunctival margins as advocated. 8,9 Histologic examination showed full-thickness atypia and loss of polarity, with initial invasion of the conjunctival substantia propria. A diagnosis of conjunctival squamous cell carcinoma was made.…”

Mass Obscuring the Globe

“…Recurrence is most related to incomplete resection; other risk factors include increased age, large lesion diameter, and high proliferation index of the tumor. 4,5,8 Excision plus cryotherapy can reduce recurrence to 5.3%. 9 Patients should also be monitored for treatment-related complications such as ocular surface toxic effects, limbal stem cell deficiency, and radiation-induced keratopathy, retinopathy, and neuropathy.…”