J Korean Ophthalmol Soc > Volume 57(3); 2016 > Article
Journal of the Korean Ophthalmological Society 2016;57(3):507-512.
DOI: https://doi.org/10.3341/jkos.2016.57.3.507    Published online March 15, 2016.
Ocular Surface Squamous Cell Carcinoma with Intraorbital Extension in a Patient with Long-Term Immunosuppression.
Eu Noo Bak, Jin Suk Ryu, Sang In Khwarg, Joo Youn Oh
1Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. bonzoo@medimail.co.kr
2Laboratory of Ocular Regenerative Medicine and Immunology, Artificial Eye Center, Clinical Research Institute, Seoul National University Hospital, Seoul, Korea.
면역억제제를 복용 중인 환자에서 안구표면 편평상피세포암의 안구 내 침범 1예
박은우1⋅류진숙2⋅곽상인1⋅오주연1,2
서울대학교 의과대학 서울대학교병원 안과학교실1, 서울대학교병원 의생명연구원 인공안구센터 안면역각막재생연구실2
Abstract
PURPOSE
To report a case of ocular surface squamous cell carcinoma with intraorbital extension in a patient with renal transplantation and long-term immunosuppressive therapy. CASE SUMMARY: A 59-year-old Korean male presented with a whitish mass in the medial limbus and conjunctiva of the right eye. The patient had undergone renal transplantation 17 years prior due to lupus nephritis and was on systemic immunosuppression with daily prednisolone (10 mg), tacrolimus (5 mg), and mycophenolate sodium (720 mg). The complete excision of the mass was performed and mitomycin C application and amniotic membrane transplantation on the excised area were combined. Histopathological examination revealed the mass was squamous cell carcinoma. There were no abnormal findings on the orbit computed tomography (CT). The patient was additionally treated with topical interferon alpha 2b 6 months postoperatively. One year later, a mass recurred at the same site in the right eye. The complete excision of the mass, mitomycin C application, cryotherapy, and amniotic membrane transplantation were performed. Orbit CT showed a 1.9 cm-sized intraorbital mass involving the medial rectus of the right eye. The orbital exenteration was performed and the intraorbital mass was histologically proven to be squamous cell carcinoma. CONCLUSIONS: Ocular surface squamous neoplasia in patients with renal transplantation and long-term immunosuppressive therapy should be monitored closely for the possibility of orbital invasion.
Key Words: Immunosuppressive therapy;Ocular surface squamous neoplasia;Orbital extension;Renal transplant;Squamous cell carcinoma


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