Successful treatment with 5-fluorouracil of conjunctival intraepithelial neoplasia refractive to mitomycin-C.
OBJECTIVE
To describe the histopathological findings and successful treatment with 5-fluorouracil (5-FU) of a conjunctival intraepithelial neoplasia with limbal stem cell deficiency that was refractive to topical mitomycin-C (MMC).


METHODS
Interventional case report.


METHODS
A 64-year-old male patient presented with a diffuse conjunctival intraepithelial neoplasia (CIN) that was excised with concurrent keratoepithelioplasty. Because of a recurrence and the presence of limbal stem cell deficiency, he was placed on topical MMC. Despite two courses of MMC, the tumor size did not decrease, and topical 5-FU was started 1 year after MMC therapy began. Limbal autograft transplantation was performed thereafter.


METHODS
The clinical and histopathologic findings including impression cytology and biomicroscopic observations.


RESULTS
After 5-FU treatment, the patient was free of the tumor clinically and cytologically, and the corneal surface had cleared. No recurrence was observed during the 30 months after the 5-FU therapy. Serious complications have not been observed.


CONCLUSIONS
Topical 5-FU may be a therapeutic option for the treatment of patients with MMC-resistant CINs. The success of 5-FU is believed to be the result of a difference in the mechanism of cytotoxicity of MMC and 5-FU or the additive effects of the two agents.
Yamamoto
Noriaki
N
Department of Ophthalmology, Gamagori City Hospital, Gamagori, Japan.
Ohmura
Tomohisa
T
Suzuki
Hiroyuki
H
Shirasawa
Haruyuki
H
D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D002278:Carcinoma in Situ / Q000188:drug therapy* / Q000473:pathology; D003230:Conjunctival Neoplasms / Q000188:drug therapy* / Q000473:pathology; D019008:Drug Resistance, Neoplasm; D004847:Epithelial Cells / Q000637:transplantation; D005472:Fluorouracil / Q000627:therapeutic use*; D006801:Humans; D016850:Limbus Corneae / Q000166:cytology; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D009364:Neoplasm Recurrence, Local; D033581:Stem Cell Transplantation; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D000903:Antibiotics, Antineoplastic; D000964:Antimetabolites, Antineoplastic; D016685:Mitomycin; D005472:Fluorouracil