Radiofrequency Blade For Removal and 5-FU Drops Postoperatively Used for Extended Conjunctival Malpighian Papilloma Management
Narrative Responses:
Purpose
To describe the successful management of an extended limbal tumor that histologically described as malpighian conjunctival papilloma using RF fine blade.
Methods
A 85 years old male patient appeared with a tumor in his temporal LE conjunctiva that covered part of the cornea with feeding vessels. Under local anesthesia the tumor was carefully excised using radiofrequency with thin sharp blade, following the rules for a malignant tumor removal. Advantages of the RF use were hemostasis, precise tissue cuts and minor tissue distortion. The big defect was closed with conjunctival flaps created with the RF knife.
Results
Healing during postoperative period was normal. After the first week, 3 cycles of 5% 5-FU drops were used (each cycle represents: 5% 5-FU drops 4 times a day for 7 days followed by 1 week off drops). During this whole period additionally autologous serum drops 4 times a day was administered in order to prevent possible 5-FU drops toxic effect to the cornea. During the 1 year of follow-up no recurrence of the tumor or other complications from the 5-FU drops were noticed.
Conclusion
Use of RF thin blade for conjunctival surgery allows precise incisions with hemostasis leading to less traumatic faster and more accurate surgery. Chemotherapeutic agent should be used as management adjunctive short after surgery specially if tumor’s characteristic are suspicious for malignancy or recurrences