Ocular surface squamous neoplasia in Ibadan, Nigeria
Introduction: Squamous cell carcinoma is the most common malignancy of the conjunctiva worldwide. Ocular surface squamous neoplasia (OSSN) describes the spectrum of ocular surface intraepithelial neoplasia, pre-invasive and invasive squamous cell carcinoma. Method: This nonrandomized stud...
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| Format: | Article |
| Language: | English |
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Thieme Medical Publishers, Inc.
2015-07-01
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| Series: | Asian Journal of Oncology |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.4103/2454-6798.173312 |
| _version_ | 1818064817723801600 |
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| author | Oluyemi Fasina |
| author_facet | Oluyemi Fasina |
| author_sort | Oluyemi Fasina |
| collection | DOAJ |
| description | Introduction: Squamous cell carcinoma is the most common malignancy of the conjunctiva worldwide. Ocular surface squamous neoplasia (OSSN) describes the spectrum of ocular surface intraepithelial neoplasia, pre-invasive and invasive squamous cell carcinoma.
Method: This nonrandomized study aims to describe the epidemiology, clinical features and evaluate the outcome of treatment in patients with histological diagnosis of OSSN managed at a single tertiary center in Ibadan, Nigeria.
Result: Twenty-five patients were managed within the study period with a mean age of 42 ± 15.3 years and male: female ratio of 1:1.5. All patients presented with growth and redness, and, visual impairment was observed in seven (28%) patients. Fifteen (60%) patients were seropositive for HIV infection and one patient (4%) had xeroderma pigmentosum. The right side was involved in 11 (44%) patients and there were no bilateral lesions. Morphologically, 18 (72%) lesions were gelatinous, six (24%) were leucoplakic while one (4%) was nodular. Twenty-two (88%) patients underwent surgical excision with alcohol kerato-epitheliectomy and cryotherapy, while three (12%) patients had lid sparing orbital exenteration. The three (12%) patients with intraepithelial neoplasm, and six (24%) who had SCC but with tumor-free margins received no adjuvant treatment post-operatively, while 13 (52%) with SCC and microscopic margin involvement were treated with four courses of 0.04% topical mitomycin C (MMC) and the three (12%) patients who had orbital exenteration were referred for radiotherapy. The average follow-up period was 12 months, no patient was lost to follow-up and none has had recurrence.
Conclusion: OSSN occurs in younger individuals, and is strongly associated with HIV infection in our environment. Early diagnosis and intervention can prevent severe ocular morbidity. Wide surgical excision with intra-operative cryotherapy and adjuvant treatment with topical MMC post-operatively seem to give good outcome in our patients. |
| first_indexed | 2024-12-10T14:42:02Z |
| format | Article |
| id | doaj.art-ef5d5994238f44fc970feb972c2a769a |
| institution | Directory Open Access Journal |
| issn | 2454-6798 2455-4618 |
| language | English |
| last_indexed | 2024-12-10T14:42:02Z |
| publishDate | 2015-07-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | Asian Journal of Oncology |
| spelling | doaj.art-ef5d5994238f44fc970feb972c2a769a2022-12-22T01:44:40ZengThieme Medical Publishers, Inc.Asian Journal of Oncology2454-67982455-46182015-07-01010210110510.4103/2454-6798.173312Ocular surface squamous neoplasia in Ibadan, NigeriaOluyemi Fasina0Department of Ophthalmology, University College Hospital, University of Ibadan, Ibadan, Oyo State, NigeriaIntroduction: Squamous cell carcinoma is the most common malignancy of the conjunctiva worldwide. Ocular surface squamous neoplasia (OSSN) describes the spectrum of ocular surface intraepithelial neoplasia, pre-invasive and invasive squamous cell carcinoma. Method: This nonrandomized study aims to describe the epidemiology, clinical features and evaluate the outcome of treatment in patients with histological diagnosis of OSSN managed at a single tertiary center in Ibadan, Nigeria. Result: Twenty-five patients were managed within the study period with a mean age of 42 ± 15.3 years and male: female ratio of 1:1.5. All patients presented with growth and redness, and, visual impairment was observed in seven (28%) patients. Fifteen (60%) patients were seropositive for HIV infection and one patient (4%) had xeroderma pigmentosum. The right side was involved in 11 (44%) patients and there were no bilateral lesions. Morphologically, 18 (72%) lesions were gelatinous, six (24%) were leucoplakic while one (4%) was nodular. Twenty-two (88%) patients underwent surgical excision with alcohol kerato-epitheliectomy and cryotherapy, while three (12%) patients had lid sparing orbital exenteration. The three (12%) patients with intraepithelial neoplasm, and six (24%) who had SCC but with tumor-free margins received no adjuvant treatment post-operatively, while 13 (52%) with SCC and microscopic margin involvement were treated with four courses of 0.04% topical mitomycin C (MMC) and the three (12%) patients who had orbital exenteration were referred for radiotherapy. The average follow-up period was 12 months, no patient was lost to follow-up and none has had recurrence. Conclusion: OSSN occurs in younger individuals, and is strongly associated with HIV infection in our environment. Early diagnosis and intervention can prevent severe ocular morbidity. Wide surgical excision with intra-operative cryotherapy and adjuvant treatment with topical MMC post-operatively seem to give good outcome in our patients.http://www.thieme-connect.de/DOI/DOI?10.4103/2454-6798.173312ibadanmitomycin cnigeriaocular surface squamous neoplasiasquamous cell carcinoma |
| spellingShingle | Oluyemi Fasina Ocular surface squamous neoplasia in Ibadan, Nigeria Asian Journal of Oncology ibadan mitomycin c nigeria ocular surface squamous neoplasia squamous cell carcinoma |
| title | Ocular surface squamous neoplasia in Ibadan, Nigeria |
| title_full | Ocular surface squamous neoplasia in Ibadan, Nigeria |
| title_fullStr | Ocular surface squamous neoplasia in Ibadan, Nigeria |
| title_full_unstemmed | Ocular surface squamous neoplasia in Ibadan, Nigeria |
| title_short | Ocular surface squamous neoplasia in Ibadan, Nigeria |
| title_sort | ocular surface squamous neoplasia in ibadan nigeria |
| topic | ibadan mitomycin c nigeria ocular surface squamous neoplasia squamous cell carcinoma |
| url | http://www.thieme-connect.de/DOI/DOI?10.4103/2454-6798.173312 |
| work_keys_str_mv | AT oluyemifasina ocularsurfacesquamousneoplasiainibadannigeria |