Peri - and Intraocular Mutilating Advanced Squamous Cell Carcinoma: ÊºMonsters Inside Your BodyÊº?
Keywords:Periocular malignancies, Surgery, Mohs, Cetuximab, Endoxan
AbstractPeriocular malignancies represent between 5% and 10% of all types of skin cancers. The incidence of eyelid (but also the periocular located) malignancies seems to differ in distribution across the continents.Â The incidence of eyelid tumours (but also the periocular located tumours) in a predominantly white population determined that BCC is the most common malignant periocular eyelid tumour in whites. This finding has been replicated consistently throughout the literature, with BCC representing 85â€“95% of all eyelid malignancies, SCC representing 3.4 - 12.6%, Seb Ca representing 0.6 - 10.2%, and both melanoma and Merkel cell carcinoma representing less than 1%. Most periocular skin cancers are associated with ultraviolet radiation (UVR) exposure. Ultraviolet radiation causes local immune suppression, which, coupled with DNA abnormalities in tumour suppressor genes and oncogenes, leads to the development of skin cancers.Â We are presenting a 62 - year - old patient with a small nodule about 2 cm away from the lower lid of his left eye. A tumour was surgically treated. Several years later there was a tumour relapse, treated with radiotherapy and subsequent chemotherapy with Endoxan and Cisplatin. After the second relapse, he was treated surgically in general anaesthesia by orbital exenteration, removal of the orbital floor and resection of zygomatic bone and the maxillary sinus. A couple of months later, he developed a tumour relapse in the scars and the area of a primary tumour with tumour progression. A possible therapy with Cetuximab or radiation therapy was discussed as a possible treatment option.
Sun MT, Andrew NH, O'Donnell B, McNab A, Huilgol SC, Selva D. Periocular squamous cell carcinoma: TNM staging and recurrence. Ophthalmology. 2015; 122(7):1512-6. https://doi.org/10.1016/j.ophtha.2015.04.002 PMid:25972255
Karabekmez FE, Selimoglu MN, Duymaz A, Karamese MS, Keskin M, Savaci N. Management of neglected periorbital squamous cell carcinoma requiring orbital exenteration. J Craniofac Surg. 2014; 25(3):729-34. https://doi.org/10.1097/SCS.0000000000000333 PMid:24481161
Nassab RS, Thomas SS, Murray D. Orbital exenteration for advanced periorbital skin cancers: 20 years experience. J Plast Reconstr Aesthet Surg. 2007; 60(10):1103-9. https://doi.org/10.1016/j.bjps.2007.02.012 PMid:17434350
Wollina U. Update of cetuximab for non-melanoma skin cancer. Expert Opin Biol Ther. 2014; 14(2):271-276. https://doi.org/10.1517/14712598.2013.876406 PMid:24387664
Preneau S, Rio E, Brocard A, Peuvrel L, Nguyen JM, QuÃ©reux G, Dreno B. Efficacy of cetuximab in the treatment of squamous cell carcinoma. J Dermatolog Treat. 2014; 25(5):424-427. https://doi.org/10.3109/09546634.2012.751481 PMid:23167307
Heath CH, Deep NL, Nabell L, Carroll WR, Desmond R, Clemons L, Spencer S, Magnuson JS, Rosenthal EL. Phase 1 study of erlotinib plus radiation therapy in patients with advanced cutaneous squamous cell carcinoma. Int J Radiat Oncol Biol Phys. 2013; 85(5):1275-1281. https://doi.org/10.1016/j.ijrobp.2012.09.030 PMid:23182701 PMCid:PMC3607201
Sullivan TJ. Topical therapies for periorbital cutaneous malignancies: indications and treatment regimens. Curr Opin Ophthalmol. 2012; 23: 439â€“442. https://doi.org/10.1097/ICU.0b013e328356ad55 PMid:22828167
Silverman N, Shinder R. What's New in Eyelid Tumors. Asia Pac J Ophthalmol (Phila). 2017; 6(2):143-152. https://doi.org/10.22608/APO.201701 PMid:28399340
How to Cite
All rights reserved.