Clinicopathological Report of Squamous Cell Carcinoma of Conjunctiva and Cornea in a Patient with AIDS

Min Kyu Yang; Bo Hyuk Kim; Mee Kum Kim; Won Ryang Wee; Joo Youn Oh

doi:10.3341/jkos.2013.54.9.1440

Journal List > J Korean Ophthalmol Soc > v.54(9) > 1009487

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Yang, Kim, Kim, Wee, and Oh: Clinicopathological Report of Squamous Cell Carcinoma of Conjunctiva and Cornea in a Patient with AIDS

Original Article

J Korean Ophthalmol Soc 2013;54(9):1440-1444.

Published online: 7 September 2013

DOI: https://doi.org/10.3341/jkos.2013.54.9.1440

Clinicopathological Report of Squamous Cell Carcinoma of Conjunctiva and Cornea in a Patient with AIDS

Min Kyu Yang, MD, Bo Hyuk Kim, MD, Mee Kum Kim, MD, PhD, Won Ryang Wee, MD, PhD, Joo Youn Oh, MD, PhD

Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea

Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea

Address reprint requests to Joo Youn Oh, MD, PhD Department of Ophthalmology, Seoul National University Hospital, #101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea Tel: 82-2-2072-3086, Fax: 82-2-741-3187 E-mail: jooyounoh77@gmail.com

∗ This study was presented as a poster at the 107th Annual Meeting of the Korean Ophthalmological Society 2012.

Received 30 November 201229 April 2013 Accepted 17 July 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To describe the clinical and histopathological findings of corneal and conjunctival squamous cell carcinoma (SCC) in a patient with acquired immune deficiency syndrome (AIDS).

Case summary

A 45-year-old Korean male who had been diagnosed of AIDS 20 years before presented with vascularized mass in the inferotemporal conjunctiva and in the cornea. The patient underwent an en bloc excisional biopsy of the mass, application of mitomycin C, and repeated cycles of freeze-thaw. Histopathology revealed dysplastic squamous epithelium in the full thickness of epithelial layer. Immunohistochemical staining for proliferation markers showed that the tumor had a high proliferation index: Ki-67 was positive throughout the full epithelial layer, and both p53 and p16 were positive. The patient had an adjuvant chemotherapy with topical interferon alpha 2b (IFNα 2b) for 8 months after surgery.

Conclusions

Given the high proliferation index of the tumor in this patient, close observation and combined adjuvant che-motherapy will be required to prevent recurrence in a patient with AIDS.

Keywords: Acquired immune deficiency syndrome, Conjunctiva, Cornea, Squamous cell carcinoma

References

1. Lee GA, Hirst LW. Ocular surface squamous neoplasia. Surv Ophthalmol. 1995; 39:429–50.

2. Basti S, Macsai MS. Ocular surface squamous neoplasia: A review. Cornea. 2003; 22:687–704.

3. Ateenyi-Agaba C. Conjunctival squamous-cell carcinoma asso-ciated with HIV infection in Kampala, Uganda. Lancet. 1995; 345:695–6.

4. Waddell KM, Lewallen S, Lucas SB. . Carcinoma of the con-junctiva and HIV infection in Uganda and Malawi. Br J Ophthalmol. 1996; 80:503–8.

5. Porges Y, Groisman GM. Prevalence of HIV with conjunctival squamous cell neoplasia in an African provincial hospital. Cornea. 2003; 22:1–4.

6. Goedert JJ, Coté TR. Conjunctival malignant disease with AIDS in USA. Lancet. 1995; 346:257–8.

7. Guech-Ongey M, Engels EA, Goedert JJ. . Elevated risk for squamous cell carcinoma of the conjunctiva among adults with AIDS in the United States. Int J Cancer. 2008; 122:2590–3.

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; 118:2133–7.e1.

9. Mahomed A, Chetty R. Human immunodeficiency virus infection, Bcl-2, p53 protein, and Ki-67 analysis in ocular surface squamous neoplasia. Arch Ophthalmol. 2002; 120:554–8.

10. Kao AA, Galor A, Karp CL. . Clinicopathologic correlation of ocular surface squamous neoplasms at bascom palmer eye in-stitute: 2001 to 2010. Ophthalmology. 2012; 119:1773–6.

11. Poole TR. Conjunctival squamous cell carcinoma in Tanzania. Br J Ophthalmol. 1999; 83:177–9.

12. Cheon HC, Lee DY, Park WC, Ahn HB. Ocular surface squamous neoplasia. Korean Ophthalmol Soc. 2006; 47:1920–8.

Figure 1.

(A-C) Anterior segment photography showed semitranslucent hypervascular mass with irregular surface involving in-ferotemporal conjunctiva and cornea. (D) Anterior segment optical coherence tomography showed flat elevated lesion with 0.29 mm thickness.

Figure 2.

(A) Hematoxylin & eosin staining showed squamous carci-noma in situ with koilocytotic atypia. (B) Immunohistochemical staining for Ki-67 showed that Ki-67 was positive throughout the full epithelial layer in 60% of the epithelium. (C) Immunohisto- chemical staining for p16 revealed positive in 70% of the epithelium. Original magnification ×100.

Figure 3.

Anterior segment photography at 8 months after excision: Partial limbal insufficiency at the excision site was observed without recurrence of the tumor.

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