Posters

Ocular surface squamous neoplasia in a liver transplant recipient on immunosuppressive therapy

Poster Details

First Author: N. İsmayilova TURKEY

Co Author(s):    B. Yaman   M. Palamar                 

Abstract Details

Purpose:

Although still unclear, ocular surface squamous neoplasia (OSSN) has a multifactorial etiology with interplay of several factors like exposure to ultraviolet radiation, immunosuppression, various chemical carcinogens and viral infections.The specific mechanism by which immunosuppression leads OSSN development is poorly understood. CD8+ T cells specific for the tumor suppressor gene TP53 have been observed in patients with OSSN, suggesting that a functional immune system may target keratinocytes expressing mutated TP53. Suppression of the immune system would presumably abrogate this response, possibly facilitating the development of OSSN. Herein, we describe a patient receiving immunosuppression after liver transplantation, who developed OSSN.

Setting:

Ege University Faculty of Medicine, Department of Ophthalmology

Methods:

Case report.

Results:

A 52-year old man presented with a amelanotic progressive growth on the left ocular surface for 4 years. His medical history included a liver transplantation for cirrhosis of the liver 12 years previously and was still on systemic immunosuppression therapy. Slit-lamp examination of the left eye showed fleshy pink elevated conjunctival lesion crossing the limbus and involving the peripheral corneal epithelium. With the clinical diagnosis of OSSN a total excision of the lesion with clear conjunctival margins, alcohol-assisted epitheliectomy of the corneal component were performed. Histopathological examination of the lesion confirmed the diagnosis of carcinoma-in situ Grade 2-3.

Conclusions:

OSSN of the conjunctiva is a low-grade malignancy with little potential for local invasion and metastasis. Metastasis of OSSN occurs in less than 1% of patients, usually to the regional lymph nodes. Immunosuppressed patients are at risk for developing opportunistic malignancies. Aggressive conjunctival squamous cell carcinoma has been reported in patients with human immunodeficiency virus infection and conjunctival epithelial neoplasia in patients with organ transplantation receiving cyclosporine therapy. Physicians should be aware that OSSN may be more aggressive in immunosuppressed patients. Systematic periodic ophthalmic evaluation of organ transplant recipients may help in early diagnosis of subtle OSSN.

Financial Disclosure:

NONE