June 2017
Volume 58, Issue 8
ARVO Annual Meeting Abstract  |   June 2017
Hepatitis C-associated ocular surface squamous neoplasia
Author Affiliations & Notes
  • Nahyoung Grace Lee
    Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
    Harvard Medical School, Boston, Massachusetts, United States
  • Angie Sanchez
    Schepens Eye Research Institute, Boston, Massachusetts, United States
    Harvard Medical School, Boston, Massachusetts, United States
  • Anna Stagner
    Pathology, Massachusetts General Hospital, Boston, Massachusetts, United States
    Harvard Medical School, Boston, Massachusetts, United States
  • Catherine J Choi
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, United States
  • Footnotes
    Commercial Relationships   Nahyoung Lee, None; Angie Sanchez, None; Anna Stagner, None; Catherine Choi, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 3349. doi:
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      Nahyoung Grace Lee, Angie Sanchez, Anna Stagner, Catherine J Choi; Hepatitis C-associated ocular surface squamous neoplasia. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3349.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : To describe a case of hepatitis C virus (HCV)-associated ocular surface squamous neoplasia (OSSN).

Methods : Hepatitis C immunofluorescence studies were performed on an ocular surface squamous cell carcinoma to demonstrate an association between the virus and the tumor.

Results : An 82 year-old Vietnamese woman with a history of chronic HCV infection presented with a 2-week history of bleeding from the right eye. She had a prior history of amblyopia, corneal neovascularization secondary to radial keratotomy, and cataract surgery with a complicated post-operative course resulting in pseudophakic bullous keratopathy.
Examination revealed light perception vision, right upper lid ptosis, right hypotropia, and a large vascular, gelatinous mass along the superior bulbar conjunctiva and cornea extending into the superior fornix (Figure1). There was active bleeding from the nasal aspect of the mass. MRI of the orbits revealed a 3.1 cm x 1.0 cm x 1.5 cm soft tissue mass of the preseptal orbit with focal hemorrhages and no evidence of postseptal, intraocular, or perineural involvement.
The patient first underwent an incisional biopsy, which revealed a poorly differentiated squamous cell carcinoma (SCC) with basaloid and acantholytic features without evidence of mucin. Decision was made to attempt a globe-sparing resection but after resection of the remaining superior conjunctival mass, the underlying sclera and cornea were also noted to be grossly abnormal and enucleation was performed. All rectus and oblique muscles were transected 5mm from the insertion. Pathological examination of the globe revealed central corneal ulceration with infiltration of tumor cells at the limbus through mid stroma, suggesting a likely corneal origin .
In addition, given the patient’s history of chronic HCV infection, anti-HCV core antibody immuno-staining was performed. The immuno-staining revealed abundant cytoplasmic HCV viral particles (Figure 2 lower panel) compared to negative control (Figure 2 upper panel), confirming the association between the virus and the malignancy.

Conclusions : In conclusion, this is an atypical presentation of a large OSSN presenting as an anterior orbital mass. While associations between OSSN and HIV and HPV, and between head and neck SCC and HCV are known, this is the first demonstration of HCV particles within OSSN. Thus, the HCV may also potentially be a viral risk factor for developing OSSN.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.




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