Diagnosis, Treatment And Follow-Up Of Anterior Segment Tumours

Published 2022 - 40th Congress of the ESCRS

Reference: PO083 | Type: Free paper | DOI: 10.82333/ytxr-jr53

Authors: Rita Basto* ¹ , Júlio Almeida ² , Joana Roque ² , Diana Silva ² , Isabel Prieto ²

¹Ophthalmology,Unidade Local de Saúde Matosinhos/ Hospital Pedro Hispano,Matosinhos, Senhora da Hora,Portugal, ²Ophthalmology,Hospital Professor Doutor Fernando Fonseca,Amadora,Portugal

Purpose

Anterior segment (AS) tumours can derive from the conjunctiva, cornea, iris and ciliary body. They comprise a wide spectrum of diagnoses, from benign lesions to malignant neoplasms with an impact on visual function and survival. Treatment depends on location, size, local extent, growth pattern and associated complications.

This work aims to evaluate the anatomical and functional results of the therapies implemented in AS tumours observed in our centre.

Setting

Hospital Professor Doutor Fernando Fonseca

Methods

Retrospective analysis of 51 eyes diagnosed with AS tumour, observed between 2010 and 2020. The sample was divided according to anatomical location: corneal-conjunctival (n=24), iris (n=23) and ciliary body (n=4). The 3 groups were subdivided into benign (n=33; 64.7%), pre-malignant (n=5; 9.8%) and malignant (n=13; 25.5%) tumours, according to clinical and pathological diagnosis.

Results

The most frequent benign tumours were melanocytic nevus and primary cysts of the conjunctiva and iris. Surgical excision was performed in the majority. Primary acquired melanosis and conjunctival intraepithelial neoplasia (CIN) represent most of pre-malignant tumours. Topical chemotherapy was performed in cases of CIN, with total regression. In the remaining, complete excision was performed, without recurrence. Malignant cases were melanoma of the conjunctiva, iris and ciliary body, squamous cell carcinoma of the conjunctiva and metastatic tumour of the iris. The surgery performed was the no-touch technique total excision with ≥2mm margins, with recurrence of the primary lesion in 2 cases.

Conclusions

Benign tumours are 3 times more frequent than malignant ones. We found an 84.8% agreement between our clinical judgment and the anatomopathological diagnosis of the lesions.

In benign cases, the anatomical and functional results are mostly good. Conservative treatment is a valid strategy, especially when the tumour, given its location, is not easily accessible surgically.

In malignant cases, due to the potential for local aggression and systemic dissemination, surgical treatment, with or without adjuvant therapies, is the strategy implemented, with periodic follow-up being essential by a multidisciplinary team.