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结膜鳞状细胞癌的眼内侵犯:临床表现、组织病理学发现及预后

Intraocular Invasion by Conjunctival Squamous Cell Carcinoma: Clinical Presentation, Histopathological Findings, and Outcome.

作者信息

Borella Ysé, Lumbroso Livia, Lévy Christine, Gardrat Sophie, Klijanienko Jerzy, Malaise Denis, Dendale Rémi, Cassoux Nathalie, Matet Alexandre

机构信息

Department of Ocular Oncology, Institut Curie, Paris, France.

Department of Pathology, Institut Curie, Paris, France.

出版信息

Ocul Oncol Pathol. 2024 Apr;10(1):32-42. doi: 10.1159/000531983. Epub 2023 Nov 15.

Abstract

INTRODUCTION

Intraocular localization of conjunctival squamous cell carcinoma (SCC) is due to scleral or corneal invasion. Herein, we describe the clinical and histopathological findings in four cases of SCC complicated by intraocular invasion, and we review cases reported in the literature and their management. We retrospectively collected and analyzed clinical characteristics, histopathology, management, and follow-up data from 4 patients with conjunctival SCC complicated by intraocular invasion. We reviewed the literature and summarized cases of intraocular invasion by conjunctival SCC reported over the last 30 years.

CASE PRESENTATIONS

Two patients presented with intraocular invasion by conjunctival SCC at diagnosis. The two others developed intraocular invasion as recurrence of conjunctival SCC, previously treated with excisional biopsy and adjuvant radiotherapy. All 4 cases had a previous history of conjunctival surgery, but no history of intraocular surgery. Three patients were managed with modified enucleation, including one that required adjuvant orbital radiotherapy. One patient required orbital exenteration. Histopathology analysis showed a well-differentiated conjunctival SCC in all cases. None developed distant localization after at least 2.5-year follow-up.

DISCUSSION/CONCLUSION: Intraocular invasion is a rare complication of conjunctival SCC. Appropriate treatment in a tertiary center and long-term follow-up are highly recommended.

摘要

引言

结膜鳞状细胞癌(SCC)的眼内定位是由于巩膜或角膜受侵所致。在此,我们描述了4例并发眼内侵犯的SCC的临床和组织病理学表现,并回顾了文献报道的病例及其治疗方法。我们回顾性收集并分析了4例并发眼内侵犯的结膜SCC患者的临床特征、组织病理学、治疗方法及随访数据。我们查阅了文献并总结了过去30年报道的结膜SCC眼内侵犯病例。

病例报告

2例患者在诊断时即出现结膜SCC的眼内侵犯。另外2例因结膜SCC复发而出现眼内侵犯,此前接受了切除活检及辅助放疗。所有4例患者既往均有结膜手术史,但无眼内手术史。3例患者接受了改良眼球摘除术,其中1例需要辅助眼眶放疗。1例患者需要眼眶内容剜除术。组织病理学分析显示所有病例均为高分化结膜SCC。至少随访2.5年后,无一例发生远处转移。

讨论/结论:眼内侵犯是结膜SCC的一种罕见并发症。强烈建议在三级中心进行恰当治疗并进行长期随访。

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