Incidence of ocular surface squamous neoplasia in pterygium specimens
Authors: Yelin Yang, Kenan Bachour, Maya Tong, Diana Khair, Judy Gaffar, Marie-Claude Robert, Paul Thompson, Louis Racine, Laura Segal, Mona Harissi-Dagher.
University of Montreal.
Author Disclosure Block: Y. Yang: None. K. Bachour: None. M. Tong: None. D. Khair: None. J. Gaffar: None. M. Robert: None. P. Thompson: None. L. Racine: None. L. Segal: None. M. Harissi-Dagher: None.
Title: Incidence of ocular surface squamous neoplasia in pterygium specimens
Purpose: Pterygium and ocular surface squamous neoplasia (OSSN) have been recognized as most likely related conditions and share similar risk factors such as UV exposure and chronic inflammation. The purpose of this study is to review the incidence of OSSN in pathology specimens sent as pterygium at a single tertiary center between 2010 and 2021.
Study Design: Retrospective chart review
Methods: This is a retrospective chart review of patients being operated on for pterygium excision between 2010 and 2021 at the Centre hospitalier de l'Université de Montréal. Data collected includes baseline demographics, results of pathology specimens, and clinical information for cases diagnosed as OSSN on pathology.
Results: 1501 patients were operated on for clinical diagnosis of pterygium between 2010 and 2021, of which 827 (55%) patients were male. 1041 specimens were sent for pathology, and the majority of the specimens were consistent with pterygium on pathology (1002/1041, 96%). There was an unexpected finding of 3 cases of OSSN (3/1041, 0.3%) and 1 case of choristoma (1/1041, 0.1%). 3% (35/1041) of specimens had other diagnoses other than pterygium, including nevus (n=12), spheroidal degeneration (n=3), pyogenic granuloma (n=3), and lymphangiectasia (n=2). The 3 cases of OSSN included a 64-year-old female of Haitian background with recurrence after previously excised pterygium, an 81-year-old male of Canadian French background and an 80-year-old male of African background with his first occurrence of pterygium. The pathology was diagnosed as carcinoma in situ, CIN grade 3, and CIN grade 1, respectively.
Conclusions: The finding of OSSN in pterygium is rare in our population, but can be clinically difficult to distinguish. It is important to send all pterygium specimens for pathology.