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. 2000 Mar;84(3):268–272. doi: 10.1136/bjo.84.3.268

Treatment of conjunctival squamous cell carcinoma with topical 5-fluorouracil

E Midena 1, C D Angeli 1, M Valenti 1, V de Belvis 1, P Boccato 1
PMCID: PMC1723406  PMID: 10684836

Abstract

AIM—To evaluate the efficacy of topical 5-fluorouracil (5-FU) alone, without concurrent surgery or radiotherapy, for the treatment of conjunctival squamous cell carcinoma.
METHODS—Eight patients affected by conjunctival squamous cell carcinoma (three recurrent cases, three incompletely excised, and two untreated cases) were treated with 1% 5-FU eye drops. Topical 1% 5-FU was administered four times daily for 4 weeks (one course). Clinical examination (biomicroscopy and photography) and morphological evaluation of conjunctival cytological specimens were used to monitor the efficacy of local chemotherapy, side effects, and recurrences.
RESULTS—All patients showed clinical regression of conjunctival carcinoma after topical 1% 5-FU treatment. Neoplastic conjunctiva was completely replaced by normal epithelium within 3 months. Mean follow up was 27 months. One patient needed two courses of local chemotherapy for recurrent disease. An acute transient toxic keratoconjunctivitis was observed in all treated cases; it was easily controlled with topical therapy. No long term side effects were found.
CONCLUSIONS—Topical 1% 5-FU is effective in the treatment of recurrent, incompletely excised, and selected untreated conjunctival squamous cell carcinomas. Topical 1% 5-FU has no major complications. This study suggests that topical conjunctival chemotherapy with 1% 5-FU may be useful, at least as adjunctive therapy, in the treatment of conjunctival squamous cell carcinoma.



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Figure 1  .

Figure 1  

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Conjunctival cytological smears of a case of recurrent squamous cell carcinoma: the picture is consistent with moderately differentiated squamous cell carcinoma (Papanicolaou, original magnification ×125 (left) and ×240 (right)).

Figure 2  .

Figure 2  

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Conjunctival cytological smears obtained 3 months after the end of one course of 5- fluorouracil (in the same patient and conjunctival area of Fig 1) show normal conjunctival epithelial cells (Papanicolaou, original magnification ×125 (left) and ×240 (right)).

Figure 3  .

Figure 3  

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Histopathological specimens of a conjunctival biopsy in a case of recurrent squamous cell carcinoma (haematoxylin and eosin, original magnification ×180 (left) and ×240 (right)).

Figure 4  .

Figure 4  

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Histopathological specimen of the case shown in Figure 3, 23 months after the end of 5-fluorouracil topical treatment. Normal conjunctiva has replaced the carcinomatous area (haematoxylin and eosin, original magnification ×125).

Figure 5  .

Figure 5  

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Clinical picture of a diffuse conjunctival squamous cell carcinoma (case 2; Table 1) before treatment with topical 1% 5-fluorouracil.

Figure 6  .

Figure 6  

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The conjunctiva in the same area as shown in Figure 5, 3 months after the end of treatment with 5-fluorouracil. No clinical signs of the lesion are present.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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