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      Squamous cell carcinoma of the conjunctiva. Case report

      case-report
      a , * , a , a , a , b
      International Journal of Surgery Case Reports
      Elsevier
      ntv, ultraviolet, DNA, deoxyribonucleic acid, HPV, human papillomavirus, HIV, human immunodeficiency virus, CIN, conjunctival intraepithelial neoplasms, UK, United Kingdom, EMA, membrane epithelial antigen, Gr, grams, FRAFF, free radial artery forearm flap, Mm, millimeters, AJCC, American Joint Committee on Cancer, SCC, squamous cell carcinoma, OSSN, ocular surface squamous neoplasia, OS, overall survival, DFS, disease-free survival, EBRT, External Beam Radiation Therapy, CT, computed tomography, IMRT, intensity-modulated radiation therapy, Squamous cell carcinoma (carcinoma, Squamous cell), Orbit, Surgery, Radial free flap, Plastic surgery, Case report

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          Abstract

          Introduction

          The prevalence of squamous cell carcinoma of the eyeball is low, and this is a rare condition. There are multiple therapeutic strategies for the treatment and depend on the degree of local involvement and extension of the tumor which, in turn, will have an impact on the patient's prognosis.

          Presentation of case

          We present a case of a patient with a mass of progressive growth on the left eyeball whit vision damage. The biopsy showed a squamous cell carcinoma of the conjunctiva, and imaging studies showed orbital invasion cT4bN0cM0, so surgery was indicated. The surgery was done with macroscopic margins of 5 mm. After resection, a radial free flap reconstruction was performed. Adjuvant treatment with radiotherapy was performed without complications. After six months, the patient manifested an improvement in his quality of life, and there is no evidence of relapse.

          Discussion

          The prevalence of squamous cell carcinoma of the conjunctiva is low. The most important risk factor is exposure to UV rays. Most are derived from conjunctival intraepithelial neoplasms. There are topical management protocols with chemotherapeutic agents and in patients with ocular or orbital invasion, enucleation and exanteration are the treatments of choice.

          Conclusion

          The squamous cell carcinoma of the conjunctive is rare. The management in the locally advanced tumors is surgical. The use of a radial free flap reconstruction is one of the reconstructive strategies to take into account, and the knowledge of additional strategies required to control the disease is important to ensure an optimal treatment.

          Highlights

          • Squamous cell carcinoma is the most frequent tumor of the eyeball.

          • The most important risk factor is the exposure to UV rays (damage in repairing DNA).

          • There are topical management protocols with multiple chemotherapeutic agents.

          • In patients with ocular or orbital invasion, the surgery is the GOLD standard of care.

          • Adjuvant therapies are useful tools in the oncological management of these patients.

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          Most cited references32

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          The SCARE 2020 Guideline: Updating Consensus Surgical CAse REport (SCARE) Guidelines

          The SCARE Guidelines were first published in 2016 and were last updated in 2018. They provide a structure for reporting surgical case reports and are used and endorsed by authors, journal editors and reviewers, in order to increase robustness and transparency in reporting surgical cases. They must be kept up to date in order to drive forwards reporting quality. As such, we have updated these guidelines via a DELPHI consensus exercise.
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            Ocular surface squamous neoplasia

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              Conjunctival and corneal intraepithelial and invasive neoplasia.

              The histopathologic findings and clinical records of 98 patients with conjunctival and corneal intraepithelial neoplasia (CIN) and 22 patients with invasive neoplasia were studied. Pathologic material was evaluated for cell type, degree of dysplasia, margins of excision, and change in pattern with recurrence. Clinical records were reviewed for demographic features, presenting symptoms, clinical appearance, therapy, and subsequent course. Recurrences occurred in 23 patients with CIN and 9 patients with invasive neoplasia. Intraocular or orbital extensions or both occurred in four patients and metastatic disease in two patients. The cell type, clinical appearance, and degree of dysplasia did not correlate with recurrence; involvement of the margins of the initial excision was an important prognostic sign for recurrence.
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                Author and article information

                Contributors
                Journal
                Int J Surg Case Rep
                Int J Surg Case Rep
                International Journal of Surgery Case Reports
                Elsevier
                2210-2612
                24 January 2022
                February 2022
                24 January 2022
                : 91
                : 106785
                Affiliations
                [a ]San José Hospital, Fundación Universitaria de Ciencias de la Salud (University Foundation of Health Sciences), FUCS, Colombia
                [b ]San Jose Hospital, Professor at Fundación Universitaria de Ciencias de la Salud (University Foundation of Health Sciences), Colombia
                Author notes
                [* ]Corresponding author at: Calle 10 #18-75, Hospital de San José, Second floor, General Surgery Office, Bogotá 110321, Colombia. rlbaquero@ 123456fucsalud.edu.co
                Article
                S2210-2612(22)00031-1 106785
                10.1016/j.ijscr.2022.106785
                8808077
                35093703
                125c888a-ef80-43fe-984c-06cf99bc9200
                © 2022 The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 5 December 2021
                : 13 January 2022
                : 20 January 2022
                Categories
                Case Report

                ntv, ultraviolet,dna, deoxyribonucleic acid,hpv, human papillomavirus,hiv, human immunodeficiency virus,cin, conjunctival intraepithelial neoplasms,uk, united kingdom,ema, membrane epithelial antigen,gr, grams,fraff, free radial artery forearm flap,mm, millimeters,ajcc, american joint committee on cancer,scc, squamous cell carcinoma,ossn, ocular surface squamous neoplasia,os, overall survival,dfs, disease-free survival,ebrt, external beam radiation therapy,ct, computed tomography,imrt, intensity-modulated radiation therapy,squamous cell carcinoma (carcinoma,squamous cell),orbit,surgery,radial free flap,plastic surgery,case report

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