García-Manzano RA, Dávila-Ruiz EO, Barker-Antonio A, García-Espinoza JA, Jarquín-Arremilla A, Peñaloza-Ramírez R

Language: Spanish
References: 12
Page: 217-221
PDF size: 194.30 Kb.

ABSTRACT

Introduction: Conjunctival squamous cell carcinoma (CCEC) is a tumor of the thin membrane that covers the ocular sclera; it originates from the limbic epithelial cells. The current pattern of presentation is aggressive, relapsing, with priority of affection for the female sex, and is associated with HIV-AIDS infection, solar radiation and infection with human papillomavirus. Clinical data mimic benign conjunctival degeneration, hence the delay in diagnosis and the high functional impact due to the disability it entails. Case report: We describe the case of a 56-year-old male patient diagnosed with HIV infection at the clinical stage of C3 treated with Atripla who presented a five-month course with a right ocular tumor of rapid growth; after its study, moderately differentiated epidermoid carcinoma of the right bulbar conjunctiva was diagnosed. It was treated by ipsilateral enucleation. Conclusion: Multiple studies confirm the link between squamous cell carcinoma of the conjunctiva and HIV-AIDS, which is a public health problem with a low index of suspicion due to clinical features similar to benign pathology, which delays diagnosis. The recognition of conjunctival tumors and the understanding of predisposing factors, biomarkers and treatment strategies are vital to decrease morbidity and disability.

REFERENCES

1. Gichuhi S, Irlam JH. Interventions for squamous cell carcinoma of the conjunctiva in VIH-infected individuals. Cochrane Database Syst Rev 2013; 28(2): CD005643.

2. Beretea CR, Desjardins L, Kouassi LJ, Coulibalya F, Kouakoua KS, Gbe K, et al. Relation entre le virus de l’immunodéficience acquis (VIH-sida) et carcinome épidermoïde conjonctival (CEC): étude épidémioclinique de 26 dossiers au service d’ophtalmologie du CHU de Treichville (Abidjan-Cote d’Ivoire). J Fr Ophtalmol 2016; 39(5): 467-73.

3. Shields CL, Chien JL, Surakiatchanukul T, Sioufi K, Lally SE, Shields JA. Conjunctival tumors: review of clinical features, risks, biomarkers, and outcomes —The 2017 J. Donald M. Gass Lecture. Asia Pac J Ophthalmol (Phila) 2017; 6(2): 109-20.

4. Jain RK, Mehta R, Badve S. Conjunctival squamous cell carcinoma due to ocular prostheses: a case report and review of literature. Pathol Oncol Res 2010; 16(4): 609-12.

5. Afrogheh AH, Jakobiec FA, Hammon R, Grossniklaus HE, Rocco J, Lindeman NI, et al. Evaluation for high-risk HPV in squamous cell carcinomas and precursor lesions arising in the conjunctiva and lacrimal sac. Am J Surg Pathol 2016; 40(4): 519-28.

6. Guech-Ongey M, Engels EA, Goedert JJ, Biggar RJ, Mbulaiteye SM. Elevated risk for squamous cell carcinoma of the conjunctiva among adults with AIDS in the United States. Int J Cancer 2008; 122(11): 2590-3.

7. Font RL, Croxatto O, Rao N. Tumors of the eye and ocular adnexa. Washington: American Registry of Pathology & Armed Forces Institute of Pathology. 2006. pp. 1-40.

8. Shields CL, Ramasubramanian A, Mellen PL, Shields JA. Conjunctival squamous cell carcinoma arising in immunosuppressed patients (organ transplant, human immunodeficiency virus infection). Ophthalmology 2011; 118(11): 2133-7.

9. Celebi AR, Kiratli H, Soylemezoglu F. Evaluation of the “hedgehog” signaling pathways in squamous and basal cell carcinomas of the eyelids and conjunctiva. Oncol Lett 2016; 12(1): 467-2.

10. Lecuona K, Stannard C, Hart G, Rice J, Cook C, Wetter J, et al. The treatment of carcinoma in situ and squamous cell carcinoma of the conjunctiva with fractionated strontium-90 radiation in a population with a high prevalence of HIV. Br J Ophthalmol 2015; 99(9): 1158-61.

11. Mahale A, Alkatan H, Alwadani S, Othman M, Suarez MJ, Price A, et al. Altered gene expression in conjunctival squamous cell carcinoma. Mod Pathol 2016; 29(5): 452-60.

12. Jacinto FA, Margo CE. Clinically occult squamous cell carcinoma of conjuntiva after topical immunotherapy for ocular surface squamous neoplasia. Can J Ophthalmol 2017; 52(4): e152-3.