AI Article Synopsis
- A case study discusses an 81-year-old man with recurrent squamous cell conjunctival carcinoma and corneal invasion, initially treated with surgery and topical therapy over ten years.
- After multiple recurrences and resistance to previous treatments, a personalized radiotherapy plan using a Rhutenium-106 plaque was implemented, targeting the affected areas for 24 hours.
- The treatment led to complete remission of the malignancy within two months, with no signs of recurrence for two years, indicating that Ru-106 brachytherapy can be an effective treatment option in similar cases.
Article Abstract
Background: We report a case of personalized exclusive brachytherapy treatment for the management of a highly recurrent squamous cell conjunctival carcinoma with corneal invasion.
Case Description: This is a case of a Caucasian 81-years-old man who presented 10 years ago to our clinic with a pink-white para-limbal mass with dilated feeder arteries and mild leukoplakia. Excisional biopsy confirmed the presence of conjunctival intraepithelial neoplasia (CIN). Successively, he underwent two 4-weeks cycles of Mytomicin C topical therapy and a second excisional surgery, due to several recurrences of the lesion. At the last relapse, the pink-white peri-limbic mass which invaded the corneal limbus, determining corneal opacification from 5- to 7-clock hours, was confirmed by anterior segment optical coherence tomography (AS-OCT). Due to resistance to MMC therapy and chronic epitheliopathy, an AS-OCT guided exclusive radiotherapy plan was set: a Rhutenium-106 CCD plaque was applied directly over the afflicted corneal surface, the corneal limbus and the neighboring sclera for 24 hours. The remission of both conjunctival and corneal malignancy was complete 2 months after surgery and no signs of recurrence were highlighted at AS-OCT analysis at the 2-year follow up.
Conclusion: Brachytherapy treatment showed optimal management of both corneal and conjunctival involvement, with a free-of-disease follow-up of 24-months. This result suggests that, in specific conditions, Ru-106 brachytherapy could be an effective option of treatment even if not associated with surgical excision.
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| http://dx.doi.org/10.1016/j.brachy.2024.02.002 | DOI Listing |
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