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Intralesional Bleomycin as an Adjunct Therapeutic Modality in Eyelid and Extraocular Malignancies and Tumors.

Meyer D, Gooding C - Middle East Afr J Ophthalmol (2015 Oct-Dec)

Bottom Line: Cases are presented to illustrate that IBI induced significant regression and reduction in tumor size and marked clinical improvement of the eyelid and orbital basal cell carcinomas, Kaposi sarcoma, and mycosis fungoides.Based on clinical experience we propose that IBI should be considered a treatment modality in select cases of the malignant eyelid and ophthalmic vascular tumors where the conventional standard of care is not possible.IBI is a reasonable alternative or adjunct to consider in such cases.

View Article: PubMed Central - PubMed

Affiliation: Division of Ophthalmology, Faculty of Medicine and Health Sciences, University of Stellenbosch, Cape Town, South Africa.

ABSTRACT
To present our recent experience with intralesional bleomycin (IBI) in nonmelanoma extraocular tumors, and present previous experience on periocular capillary hemangiomas and orbital lymphangiomas in a tertiary referral hospital. This was a retrospective descriptive study of patients with eyelid and extraocular malignancies where conventional therapies failed, or surgery was contraindicated or refused and were offered IBI as an alternate therapy. All patients were recruited from the Oculoplastics Clinic at Tygerberg Academic Hospital, Cape Town, South Africa. A solution containing 1 international unit of bleomycin per milliliter saline was injected intralesionally together with 2% lignocaine in a ratio of 4:1. The injected volume was calculated to be equivalent to the estimated volume of the lesion. A multipuncture technique with a 29-gauge needle was used. Patients requiring retreatment were injected every 4-8 weeks until satisfactory clinical endpoints were achieved. Our previous experience with IBI in extensive capillary hemangiomas and orbital lymphangiomas is reviewed. Cases are presented to illustrate that IBI induced significant regression and reduction in tumor size and marked clinical improvement of the eyelid and orbital basal cell carcinomas, Kaposi sarcoma, and mycosis fungoides. The improvements obviated the need for further surgical intervention in most cases. Based on clinical experience we propose that IBI should be considered a treatment modality in select cases of the malignant eyelid and ophthalmic vascular tumors where the conventional standard of care is not possible. IBI is a reasonable alternative or adjunct to consider in such cases.

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Related in: MedlinePlus

(a) Basal cell carcinoma involving the right lower lid margin before treatment. (b) One year after 4 intralesional bleomycin treatments. No signs of tumor recurrence clinically
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Figure 3: (a) Basal cell carcinoma involving the right lower lid margin before treatment. (b) One year after 4 intralesional bleomycin treatments. No signs of tumor recurrence clinically

Mentions: An 80-year-old Caucasian male was referred with a biopsy-proven BCC of the right lower lid. His general health was fragile and with inoperable unstable angina he was a procedure risk even under local anesthesia or sedation. IBI was offered and administered 4 times over the course of 6 months. Total biomicroscopic tumor regression was achieved with good anatomical outcome [Figure 3a and b]. Six monthly follow-ups was maintained, and after 4 years the patient remains alive (in spite of unstable angina) and presented recently with signs of a small tumor recurrence at the temporal edge of the treated area. This was successfully re-treated with additional IBI.


Intralesional Bleomycin as an Adjunct Therapeutic Modality in Eyelid and Extraocular Malignancies and Tumors.

Meyer D, Gooding C - Middle East Afr J Ophthalmol (2015 Oct-Dec)

(a) Basal cell carcinoma involving the right lower lid margin before treatment. (b) One year after 4 intralesional bleomycin treatments. No signs of tumor recurrence clinically
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4660524&req=5

Figure 3: (a) Basal cell carcinoma involving the right lower lid margin before treatment. (b) One year after 4 intralesional bleomycin treatments. No signs of tumor recurrence clinically
Mentions: An 80-year-old Caucasian male was referred with a biopsy-proven BCC of the right lower lid. His general health was fragile and with inoperable unstable angina he was a procedure risk even under local anesthesia or sedation. IBI was offered and administered 4 times over the course of 6 months. Total biomicroscopic tumor regression was achieved with good anatomical outcome [Figure 3a and b]. Six monthly follow-ups was maintained, and after 4 years the patient remains alive (in spite of unstable angina) and presented recently with signs of a small tumor recurrence at the temporal edge of the treated area. This was successfully re-treated with additional IBI.

Bottom Line: Cases are presented to illustrate that IBI induced significant regression and reduction in tumor size and marked clinical improvement of the eyelid and orbital basal cell carcinomas, Kaposi sarcoma, and mycosis fungoides.Based on clinical experience we propose that IBI should be considered a treatment modality in select cases of the malignant eyelid and ophthalmic vascular tumors where the conventional standard of care is not possible.IBI is a reasonable alternative or adjunct to consider in such cases.

View Article: PubMed Central - PubMed

Affiliation: Division of Ophthalmology, Faculty of Medicine and Health Sciences, University of Stellenbosch, Cape Town, South Africa.

ABSTRACT
To present our recent experience with intralesional bleomycin (IBI) in nonmelanoma extraocular tumors, and present previous experience on periocular capillary hemangiomas and orbital lymphangiomas in a tertiary referral hospital. This was a retrospective descriptive study of patients with eyelid and extraocular malignancies where conventional therapies failed, or surgery was contraindicated or refused and were offered IBI as an alternate therapy. All patients were recruited from the Oculoplastics Clinic at Tygerberg Academic Hospital, Cape Town, South Africa. A solution containing 1 international unit of bleomycin per milliliter saline was injected intralesionally together with 2% lignocaine in a ratio of 4:1. The injected volume was calculated to be equivalent to the estimated volume of the lesion. A multipuncture technique with a 29-gauge needle was used. Patients requiring retreatment were injected every 4-8 weeks until satisfactory clinical endpoints were achieved. Our previous experience with IBI in extensive capillary hemangiomas and orbital lymphangiomas is reviewed. Cases are presented to illustrate that IBI induced significant regression and reduction in tumor size and marked clinical improvement of the eyelid and orbital basal cell carcinomas, Kaposi sarcoma, and mycosis fungoides. The improvements obviated the need for further surgical intervention in most cases. Based on clinical experience we propose that IBI should be considered a treatment modality in select cases of the malignant eyelid and ophthalmic vascular tumors where the conventional standard of care is not possible. IBI is a reasonable alternative or adjunct to consider in such cases.

Show MeSH
Related in: MedlinePlus