Clinicopathological Analysis and Demographic Features of Ocular Malignancies

Figures & data

Table 1 Demographic Characteristics of Patients with Ocular Malignancies (N = 246)

Characteristics	No. of Patients	Percentage (%)
Gender
Male	138	56.10
Female	108	43.90
Age group in years
0–5	47	19.11
6–15	16	6.50
16–25	1	0.41
26–35	4	1.63
36–45	16	6.50
46–55	39	15.85
56–65	65	26.42
≥65	58	23.58
Place of residence
Urban	34	13.82
Semi-urban	50	20.33
Rural	162	65.85
Educational level
Illiterate	151	61.38
Preschool	40	16.26
Primary	25	10.16
Middle	11	4.47
Secondary	10	4.07
Graduate	4	1.63
Postgraduate	5	2.03

Table 2 Clinicopathological Characteristics of Patients (N = 246)

Characteristics	No. of Patients	Percentage (%)
Type of malignancy
Primary ocular or adnexal malignancy	226	91.87
Secondary invasion from adjacent structures, including:	13	5.28
Paranasal sinuses and nasopharynx	10	4.07
Intracranial tumors	3	1.22
Secondary invasion from metastatic carcinomas elsewhere, including:	7	2.85
Breast	3	1.22
Lungs	2	0.81
Testes	1	0.41
Prostate	1	0.41
Laterality
Right eye	168	68.29
Left eye	64	26.02
Bilateral	14	5.69
Location of tumor
Eyelid and periocular structures	92	37.40
Orbit	72	29.27
Ocular surface (ie the conjunctiva and cornea)	46	18.70
Intraocular	36	14.63
Lymph node metastasis
Present	43	17.48
Absent	203	82.52
Distant metastasis
Present	11	4.47
Absent	235	95.53

Table 3 Pathological Diagnoses According to Malignancy Type (N = 246)

Pathological Diagnosis	No. of Patients	Percentage (%)
Eyelid/periocular malignancies
Sebaceous gland carcinoma	42	17.07
Basal cell carcinoma	26	10.57
Squamous cell carcinoma	18	7.32
Melanoma	6	2.44
Orbital malignancies
Retinoblastoma	23	9.35
Rhabdomyosarcoma	16	6.50
Lacrimal gland adenocystic carcinoma	10	4.07
Osteosarcoma	3	1.22
Squamous cell carcinoma (secondary extension from the paranasal sinuses and nasopharynx)	13	5.28
Metastatic adenocarcinoma	7	2.85
Intraocular malignancies
Retinoblastoma	24	9.75
Uveal melanoma	12	4.88
Ocular surface malignancies
Squamous neoplasia	40	16.26
Melanoma	4	1.63
Angiosarcoma	2	0.81

Figure 1 (A) Clinical photograph of a 80-year-old female patient with a left upper eyelid nodulo-ulcerated sebaceous gland carcinoma with preauricular lymph node metastasis. (B) Microphotograph of a moderately differentiated sebaceous gland carcinoma showing lobules of malignant cells with sebaceous differentiation.

Figure 2 (A) Clinical photograph of a pigmented basal cell carcinoma on the left lower eyelid. (B) Microphotograph of a basal cell carcinoma showing nests of atypical pigment-laden basal cells with peripheral palisading and mitotic figures.

Figure 3 (A) Clinical photograph of a male child with an orbital retinoblastoma on the right eye. (B) Computed tomography in the sagittal view showing intracranial extension with lymph node and cerebral metastasis.

Figure 4 (A) Clinical photograph of a 15-year-old male patient with an orbital rhabdomyosarcoma in the left superior rectus muscle of the eye showing non-axial proptosis, marked chemosis and exposure keratopathy. (B) Computed tomography in the coronal view showing a large, round, well-defined, enhancing mass over the superior orbit, pushing the globe inferiorly. (C) Clinical photograph after five cycles of systemic neoadjuvant chemotherapy (vincristine, doxorubicin, and cyclophosphamide) showing complete regression of tumor and alopecia. (D) Immunohistochemical stains reveal positivity for vimentin within the cytoplasm of rhabdomyosarcoma cells.

Figure 5 (A) Clinical photograph of a giant ocular surface squamous neoplasia (about 250°) in the right eye. (B) Clinical photograph after four cycles of topical 5FU drops.

Table 4 Histopathological Differentiation of Eyelid Malignancies (N= 92)

Histopathological Differentiation	No. of Patients	Percentage (%)
Well-differentiated	34	36.96
Moderately differentiated	30	32.61
Poorly differentiated/undifferentiated	28	30.43

Table 5 Distribution of Cases According to Treatment Procedures Undertaken by Patients (N= 246)

Treatment Procedures	No. of Patients	Percentage (%)
Primary surgical excision and reconstruction	68	27.64
Neoadjuvant chemotherapy followed by surgical excision	46	18.70
Topical chemotherapy/immunotherapy	38	15.45
Exenteration/enucleation and adjuvant chemotherapy	48	19.51
Palliative chemotherapy and EBRT	46	18.70

Abbreviation: ERBT, external beam radiation therapy.

Table 6 Distribution of Study Subjects According to Treatment Outcomes After Six Months (N = 246)

Outcomes	No. of Patients	Percentage (%)
Complete response/cure	123	50.00
Partial response	38	15.45
Disease progression	32	13.01
Recurrence	41	16.67
Death	12	4.88