Ocular surface squamous neoplasia masquerades: Clinical profile and outcome.

IF 2.1 4区 医学 Q2 OPHTHALMOLOGY
Shirali Gokharu, Deepanjali Arya, Deepender Chauhan, Sima Das
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Abstract

Purpose: The diagnosis of ocular surface squamous neoplasia (OSSN) is primarily clinical, confirmed through histopathology, cytology, or imaging. This study describes a series of OSSN patients with atypical clinical presentation masquerading non-neoplastic etiologies, identifies clinical features distinguishing OSSN from benign lesions, and thus aids clinicians in early diagnosis and prompt management.

Methods: A retrospective review was conducted on medical records of OSSN patients, and patients initially diagnosed with anterior segment infection or inflammation were identified. Data collected included clinical presentation, initial diagnosis and treatment, response to treatment, final diagnosis, treatment type and outcome, and clinical clues to the diagnosis.

Results: In the study period, 153 OSSN patients were identified from medical records of which 11 patients (7.2%) were initially diagnosed as anterior segment infection or inflammation. One patient presented with limbal stem cell deficiency, two with nodular episcleritis and necrotizing scleritis, and eight with various corneal involvement such as dendritic ulcer, corneal degeneration/dystrophy, corneal dermoid, exposure keratopathy, peripheral ulcerative keratitis, and perforated corneal ulcer. Three underwent extended enucleation due to intraocular spread, two required excision biopsies with adjuvant topical therapy, and the remaining patients were treated with topical therapy (Interferon α-2b 1% and/or mitomycin-C 0.04%). One patient was lost to follow up, one had a recurrence, and nine achieved complete resolution at mean follow-up of 18 months.

Conclusion: OSSN can mimic ocular surface infection, inflammation, or degeneration. A meticulous anterior segment evaluation can provide clinical clues to diagnosis which can be confirmed on histopathology.

假面具眼表鳞状瘤变:临床概况和结果。
目的:眼表鳞状瘤变(OSSN)的诊断主要是临床,通过组织病理学、细胞学或影像学证实。本研究描述了一系列不典型临床表现、伪装为非肿瘤性病因的OSSN患者,确定了OSSN与良性病变的临床特征,从而帮助临床医生早期诊断和及时治疗。方法:对OSSN患者的病历进行回顾性分析,筛选出最初诊断为前段感染或炎症的患者。收集的资料包括临床表现、初诊治、治疗反应、最终诊断、治疗类型及结局、诊断的临床线索。结果:在研究期间,从病历中发现153例OSSN患者,其中11例(7.2%)最初诊断为前段感染或炎症。1例患者表现为角膜缘干细胞缺乏,2例表现为结节性巩膜炎和坏死性巩膜炎,8例表现为各种角膜受累,如树突状溃疡、角膜变性/营养不良、角膜皮样、暴露性角膜病变、周围性溃疡性角膜炎和穿孔性角膜溃疡。3例因眼内扩散而行延长去核术,2例需要切除活检并辅以局部治疗,其余患者接受局部治疗(干扰素α-2b 1%和/或丝裂霉素c 0.04%)。1例失访,1例复发,9例平均随访18个月完全缓解。结论:OSSN可模拟眼表感染、炎症或变性。细致的前节段评估可为临床诊断提供线索,并可在组织病理学上得到证实。
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来源期刊
CiteScore
3.80
自引率
19.40%
发文量
1963
审稿时长
38 weeks
期刊介绍: Indian Journal of Ophthalmology covers clinical, experimental, basic science research and translational research studies related to medical, ethical and social issues in field of ophthalmology and vision science. Articles with clinical interest and implications will be given preference.
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