Use of Mitomycin C in the treatment of conjunctival and corneal squamous cell carcinoma. a case report

Purpose. Corneal conjunctival squamous carcinoma is a rare form of slowly progressive carcinoma of low malignant potential. Mitomycin C (MMC) is a chemiotherapic antibiotic isolated from Streptomyces Caespitosus and medical literature reports efficacy of MMC in the treatment of squamous cell carcinoma. We present a case of conjunctival and corneal squamous cell carcinoma which was treated with both surgical excision and topical use of MMC 0.02%. Methods. A 78-year old man with a red-grey vascularized elevated epithelial lesion that started at the conjunctiva and extended past the corneoscleral limbus on to the cornea for about 1.5 mm. The patient was given surgical exeresis of the conjunctival neoformation and the histological exam highlighted a corneal conjunctival squamous cell carcinoma. after three monthes a recurrence of the neoformation was displayed and we therefore decided to start topical MMC 0.02% eye drops treatment four times daily for 7 days. Four cycles of treatment were done with a one-week interval during which only sodium hyaluronate 0.4% lubricant eye drops were administered. Results. During the period of treatment with the MMC 0.02% eye drops, the patient did not display any adverse systemic or ocular reactions. At the end of the treatment we found a complete regression of the disease. Twelve months after treatment he was without conjunctival and corneal epithelial dysplasia. Conclusions. This case highlights the efficacy of MMC 0.02% eye drops in the treatment of conjunctival and corneal squamous cell carcinoma that can avoid the topical use with sponge of MMC at higher concentration that it would present a not predictable long term effects on the conjunctival fornix and on lachrymal secretion