Successful treatment with 5-fluorouracil of conjunctival intraepithelial neoplasia refractive to mitomycin-C

Ophthalmology. 2002 Feb;109(2):249-52. doi: 10.1016/s0161-6420(01)00926-5.


Purpose: To describe the histopathological findings and successful treatment with 5-fluorouracil (5-FU) of a conjunctival intraepithelial neoplasia with limbal stem cell deficiency that was refractive to topical mitomycin-C (MMC).

Design: Interventional case report.

Intervention: A 64-year-old male patient presented with a diffuse conjunctival intraepithelial neoplasia (CIN) that was excised with concurrent keratoepithelioplasty. Because of a recurrence and the presence of limbal stem cell deficiency, he was placed on topical MMC. Despite two courses of MMC, the tumor size did not decrease, and topical 5-FU was started 1 year after MMC therapy began. Limbal autograft transplantation was performed thereafter.

Main outcome measures: The clinical and histopathologic findings including impression cytology and biomicroscopic observations.

Results: After 5-FU treatment, the patient was free of the tumor clinically and cytologically, and the corneal surface had cleared. No recurrence was observed during the 30 months after the 5-FU therapy. Serious complications have not been observed.

Conclusions: Topical 5-FU may be a therapeutic option for the treatment of patients with MMC-resistant CINs. The success of 5-FU is believed to be the result of a difference in the mechanism of cytotoxicity of MMC and 5-FU or the additive effects of the two agents.

Publication types

  • Case Reports

MeSH terms

  • Antibiotics, Antineoplastic / therapeutic use*
  • Antimetabolites, Antineoplastic / therapeutic use*
  • Carcinoma in Situ / drug therapy*
  • Carcinoma in Situ / pathology
  • Conjunctival Neoplasms / drug therapy*
  • Conjunctival Neoplasms / pathology
  • Drug Resistance, Neoplasm
  • Epithelial Cells / transplantation
  • Fluorouracil / therapeutic use*
  • Humans
  • Limbus Corneae / cytology
  • Male
  • Middle Aged
  • Mitomycin / therapeutic use*
  • Neoplasm Recurrence, Local
  • Stem Cell Transplantation
  • Transplantation, Autologous
  • Treatment Outcome


  • Antibiotics, Antineoplastic
  • Antimetabolites, Antineoplastic
  • Mitomycin
  • Fluorouracil