재발한 안구표면 편평세포 암종에서 인터페론 Beta-1b, 마이토마이신 병합 치료 1예
A Case of Combination Therapy of IFN-β1b and Mitomycin-C on Recurred Ocular Surface Squamous Neoplasia
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목적: 수술적 절제 후 재발한 안구표면 편평세포 암종에서 interferon beta-1b (IFN-β1b)와 mitomycin-C (MMC) 병합 치료 1예를경험하였기에 이를 보고하고자 한다. 증례요약: 72세 여자 환자가 우안 내측 결막의 흰색 종괴를 주된 소견으로 내원하였다. 우안 내측 각막 윤부에 젤라틴 모양의 흰색결절 병변이 관찰되어 편평세포 암종 의심 하에 수술적 절제 및 냉동 응고 요법을 시행하였다. 조직학적 검사상 편평세포 상피내암으로 확인되었다. 1년 뒤 우안 각막 병변 재발하여 재발한 편평세포 상피내암 진단 하에 IFN-β1b (1 mIU/mL) 및 0.02% MMC를 하루에4번씩 4주 동안 점안하였다. 병합 치료 1개월 후 재발한 병변은 사라졌으며 이후 MMC는 중단하고 IFN-β1b만 하루에 2번 점안으로1개월 유지 후 중단하였다. 병합 치료 완전 중단 후 12개월째 시행한 검사에서 재발한 소견 보이지 않았으며 약제에 의한 합병증도발견되지 않았다. 결론: 수술적 절제 후 재발한 안구표면 편평세포 암종에서 IFN-β1b와 MMC의 병합 치료는 매우 빠르고 우수한 치료 효과를 가지며큰 합병증 없이 비교적 안전하게 사용할 수 있는 방법으로 생각된다.
Abstract
Purpose: To report a case of combination therapy with interferon β1b (IFN-β1b) and mitomycin-C (MMC) for recurrent ocular surface squamous neoplasia (OSSN). Case summary: A 72-year-old female presented with a white mass at the medial conjunctiva of the right eye. A gelatinous, nodular white lesion was observed near the medial limbus of the right eye. On histological examination, it was diagnosed as squamous cell carcinoma in situ. A white nodule was found at the resection site 1 year after the resection. IFN-β1b (1 mIU/mL) and 0.02% MMC were administered daily with a diagnosis of recurrent OSSN. IFN-β1b was instilled four times a day for 1 month, while MMC was instilled four times a day for 4 weeks. After 1 month of the combination treatment, the lesion disappeared. MMC was stopped, while IFN-β1b was reduced to twice daily instillation, maintained for 1 month, and then stopped. On examination 12 months after discontinuation of the combination treatment, there were no recurrences or drug-related complications. Conclusions: Combination therapy with IFN-β1b and MMC for recurrent OSSN after surgical resection was relatively safe with no major complications.
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