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This document summarizes a case study of a 32-year-old HIV-positive male who presented with a mass in his left eye. Examination found a placoid lesion on the conjunctiva encroaching on the cornea. A biopsy found hyperplastic stratified squamous epithelium with dysplastic changes. The mass was excised and cryotherapy with mitomycin C drops were administered. Follow up found no recurrence of intraepithelial neoplasia or metastasis up to 9 months later. The case demonstrates that unilateral gelatinous papilliform squamous cell carcinoma in AIDS patients can be treated effectively with complete surgical excision and cryotherapy to prevent recurrence.

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366 views12 pages

Poster PPT Ossn

This document summarizes a case study of a 32-year-old HIV-positive male who presented with a mass in his left eye. Examination found a placoid lesion on the conjunctiva encroaching on the cornea. A biopsy found hyperplastic stratified squamous epithelium with dysplastic changes. The mass was excised and cryotherapy with mitomycin C drops were administered. Follow up found no recurrence of intraepithelial neoplasia or metastasis up to 9 months later. The case demonstrates that unilateral gelatinous papilliform squamous cell carcinoma in AIDS patients can be treated effectively with complete surgical excision and cryotherapy to prevent recurrence.

Uploaded by

Shilpa B K
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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P-180

OCULAR SURFACE DISORDERS

PRESENTING AUTHOR: DR.SRIVIDYA


CHIEF AUTHOR: DR.KAVITA SALAGAR
(KOS-NO:1422).
CO-AUTHOR: DR.VISHWANATH REDDY.
DR.VEERESH KORWAR.
DR.VINEETH BHIMSHETTY.

M R MEDICAL COLLEGE,KALABURGI

AUTHOR HAS NO FINANCIAL INTEREST


INTRODUCTION
 OCULAR SURFACE SQUAMOUS NEOPLASIA is a
uncommon tumor.

 LEE and HERST describes spectrum of conjunctival, corneal


intraepithelial Neoplasia .

 Manifest as Dysplasia, CIN and invasive squamous cell carcinoma.

 Risk factors include a history of intense sunlight exposure, male sex,


outdoor occupations, advanced age, smoking, light complexion, AIDS,
Xeroderma pigmenntosa, HPV 6,11,16, 18

 The pathogenesis of tumors appears to be disordered epithelial


maturation induced by various irritants.
People with AIDS tends to
develop conjunctival and
corneal SSC at a young
age and aggressive than the
typical conjunctiva scc.

No of OSSN Templeton
cases found an
relative to total average
No of orbital
tumor ranges
OSSN incidence of
0.13/1 lakh
from 4% to population,
29%.

Primarily occurs in older


males with incidence of
1.9/1 lakh
32 year male presented with complaints of Mass in left eye since 8
months
Mass was Insidious in onset,gradually progressive

Dimension of vision in left eye since 3 months insidious in onset


gradually progressive .
No History of Trauma

Patient was diagnosed to be HIV positive 1 year back


On regular ART treatment (Zidovudine-Lamivudine-Nevirapine

OD OS
VA 20/20 20/30

With 20/20 20/20


pinhole
Near Vision N6 N6
LEFT EYE

• Placoid lesion with shiny velvetty


•Encroaching 2mm on cornea with
elevated surface at interpalpebral
Tufted Feeder vessels and surface
fissure conjunctiva straddling the
keratin inferiorly.
limbus

Rest all anterior segment was normal


Total mass excision done
Excisional biopsy sent for HPR.

Topical chemotherapy using


CRYOTHERAPHY mitomycin C (0.02%) drops
[Freeze-thaw technique] administered 4 times daily
for 1 to 2 weeks
HISTOPATHOLOGY GOLD STANDARD
TECHNIQUE

• Report revealed Hyperplastic,


Acanthotic Stratified
Squamous Epithelium(SSE)

•Dysplastic changes and


subepithelial infilterate.

• Tumor Cells were


arranged in a nest and
scattered singly.
No symblepharon, restricted ocular
motility, or scleral melting was seen
following Cryotherapy.

Patient was followed up regularly.

No recurrent intraepithelial neoplasia


even upto 9 months following the
excision.

No metastasis noted.
CONCLUSION
• Unilateral gelatinous papilliform squamous cell carcinoma in
patients with concurrent AIDS are rare, particularly likely to
exhibit rapidly progressive malignant conjunctival and corneal
neoplasms of the SSE and metastasis of those neoplasms.

• Role of complete surgical excision + cryotherapy +


mitomycin therapy

• It has favourable outcome with prevention of recurrence.


REFERENCES
 British Journal of Ophthalmology 2012:84: Page
268-272.
 Delhi Journal of Ophthalmology 2012;23(2):89-96.
 Albert and Jakobiec, Principles and Practice of
Ophthalmology, 3rd Edition, Vol-3, Page 3584-3586.
 American Academy of Ophthalmology 2015 Edition,
Page 2001.
 Yanoff and Duker, Ophthalmology, 4th Edition,
Page 196-198.

THANK YOU

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