Spontaneous regression of presumed ocular surface squamous neoplasia: A report of 8 cases

To report the phenomenon of spontaneous regression in presumed ocular surface squamous neoplasia (OSSN).

Retrospective chart review of clinically diagnosed cases of OSSN during 2016 to 2019.

Of the 449 OSSN lesions, spontaneous regression was seen in 8 lesions (2%). The mean age at diagnosis of OSSN was 37 years (median, 36 years; range, 21 to 59 years). All were males with unilateral, treatment-naïve tumors. Mean duration of symptoms was 3 months (median, 2 months; range, 1 to 12 months). All tumors arose within the interpalpebral region, located in the nasal quadrant in 88% (n = 7) and in temporal quadrant in 12% (n = 1). The mean tumor diameter was 4 mm (median, 4 mm; range, 3 to 5 mm). Lesions showed nodular (n = 4; 50%) or placoid (n = 4; 50%) morphology. The other features included keratin production and intrinsic vascularity (n = 8; 100%), feeder vessels (n = 4; 50%), and intratumoral pigmentation (n = 4; 50%). The diagnosis of OSSN was confirmed by classic anterior segment optical coherence tomography (AS-OCT) features. Tumors regressed after a mean period of 5 months (median, 4 months; range, <1 to 17 months) from presumed onset and a mean period of 2 months (median, 1 month; range, <1 to 6 months) from presentation to the clinic. No recurrences were noted at a mean follow up of 37 months (median, 35 months; range, 17 to 52 months) after spontaneous regression of tumors.

OSSN can spontaneously regress in 2% of cases. Immune-mediated reversal of dysplastic changes may explain this phenomenon.

In this study, spontaneous regression of presumed ocular surface squamous neoplasia was noted in 2% patients. Tumor regression resulted in restoration of normal epithelial architecture and no recurrences were observed during the follow-up period.