Intralesional neoadjuvant methotrexate in the management of large eyelid squamous cell carcinoma: a case report
Author: Ángeles Morón Bernal
Base Hospital / Institution: Hospital Universitario Virgen de Valme
ePoster presentation
Abstract ID: 25-287
Purpose
To report a case of a patient diagnosed with a large squamous cell carcinoma (SCC) of the eyelid, who was treated with intralesional neoadjuvant methotrexate, showing a remarkable therapeutic response.
Methods
A case of a female patient presenting with eyelid SCC, treated with intralesional methotrexate (MTX), was documented. The patient´s clinical presentation, diagnostic process, treatment, and outcomes were detailed.
Results
A 95-year-old women patient consulted for a rapidly enlarging mass located in the lateral canthus of the right eye. On examination, a large pedunculated tumor measuring 4,5 cm x 3 cm with papillomatous appearance and a centralulceration was observed. Histopathological examination of the lesion revealed a SCC.Before the first MTXAi injection, the patient underwent control laboratory tests, including complete hematological tests and liver and renal function evaluations. Additionally, a computed tomography (TC) scan of the orbits and head and neck was performed, which did not show any involvement of deep structures or pathological lymph nodes.The treatment consisted of a total of six weekly intralesional MTX injections. Clinical response was reevaluated one week after the final injection, at which time a significant reduction in tumor size was observed, leaving a smooth, cicatricial lesion measuring 8 mm x 9 mm. Despite this reduction, a small residual lesion remained, leading to the decision to perform surgical excision.Complete excision of the remaining lesion was undertaken, followed by reconstruction of the lateral canthus. Histopathological examination of the excised tissue revealed no evidence of malignant cells.
Conclusion
Squamous cell carcinoma are highly aggressive tumors capable of reaching large dimensions. In our patient´s case, complete excision of the initial lesion would have been a challenging procedure due to the tumor´s size and thepatient´s comorbidities. Neoadjuvant intralesional methotrexate therapy facilitated a reduction in tumor size prior to surgery, ultimately resulting in the complete eradication of malignant cells.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Aitor Joaquín | Castilla Lázpita | Hospital Universitario Virgen de Valme |
| Irene | Suárez Vergne | Hospital Universitario Reina Sofía |
| Cristina | Escorial Albéndiz | Hospital Universitario Virgen de Valme |
