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To study the efficacy of topical and combined topical and subconjunctival interferon alfa 2b (IFN alfa 2b) in the treatment of recurrent conjunctival intraepithelial neoplasia (CIN) in those patients who present resistance or intolerance to topical mitomycin C (MMC) treatment or when it is not indicated.Four patients (age range from 52 to 70) with histological confirmation of recurrent CIN were studied prospectively. Two patients were resistant to topical MMC, another one did not tolerate it, and in the last case, this treatment was not indicated due to a stem cell insufficiency associated to a trophic corneal ulcer. Three patients were given just topical interferon (1 million IU/ ml four times a day for three months), while the last one received topical therapy and subconjunctival IFN alfa 2b injections (3 millions IU/ 0.5 ml).Complete regression of the tumour was evident in all cases. sixteen to 24 months after treatment no patient had clinical evidence of recurrence. No side effects were observed in any patient, not even with subconjunctival administration.IFN alfa 2b is effective as an alternative treatment to topical MMC in selected cases of recurrent CIN.

espanolObjetivo: Objetivo: Mostrar la eficacia del interferon alfa- 2b topico (IFN alfa- 2b) y subconjuntival para el tratamiento de carcinomas conjuntivales intraepiteliales (CIN) en pacientes en los cuales existe resistencia, intolerancia o contraindicacion para el tratamiento con Mitomicina C ( MMC) topica. Metodo: Se trataron 4 ojos de 4 pacientes con edades comprendidas entre los 52 y los 70 anos, con diagnostico histopatologico de CIN recidivante. En dos de los pacientes se desarrollo una resistencia a la MMC topica, en otro paciente hubo intolerancia al tratamiento y en el ultimo existia contraindicacion para el empleo de MMC debido a una insuficiencia limbar con ulcera trofica central. Tres de los pacientes fueron tratados exclusivamente con IFN alfa- 2b topico (1 millon UI/ ml 4 veces/dia durante 3 meses), mientras que otro preciso de la adicion de inyecciones subconjuntivales (3 millones UI/ 0.5 ml). Resultados: Se produjo desaparicion completa de la lesion en todos los casos. El seguimiento de los pacientes oscila entre los 16 y 24 meses (media: 20.25 meses) sin evidencia de recurrencia clinica. No se observaron efectos secundarios en ninguno de los cuatro pacientes, ni siquiera en el que recibio la administracion subconjuntival. Conclusiones: En esta serie el IFN α- 2b se muestra efectivo como tratamiento alternativo a la MMC tσpica en casos seleccionados de CIN recidivantes con resistencia, intolerancia o contraindicaciσn a la MMC. EnglishPurpose: To study the efficacy of topical and combined topical and subconjunctival interferon alfa 2b (IFN alfa 2b) in the treatment of recurrent conjunctival intraepithelial neoplasia (CIN) in those patients who present resistance or intolerance to topical mitomycin C (MMC) treatment or when it is not indicated. Methods: Four patients (age range from 52 to 70) with histological confirmation of recurrent CIN were studied prospectively. Two patients were resistant to topical MMC, another one did not tolerate it, and in the last case, this treatment was not indicated due to a stem cell insufficiency associated to a trophic corneal ulcer. Three patients were given just topical interferon (1 million IU/ ml four times a day for three months), while the last one received topical therapy and subconjunctival IFN alfa 2b injections (3 millions IU/ 0.5 ml) . Results: Complete regression of the tumour was evident in all cases. sixteen to 24 months after treatment no patient had clinical evidence of recurrence. No side effects were observed in any patient, not even with subconjunctival administration. Conclusions: IFN alfa 2b is effective as an alternative treatment to topical MMC in selected cases of recurrent CIN.

To review the most common clinical signs and symptoms of inflammatory pseudotumor of the bladder in children and to distinguish this benign lesion from malignant neoplasms such as rhabdomyosarcoma and leiomyosarcoma.Two cases os pseudosarcomatous tumor of the bladder in children are described. In the first patient, the tumor had appeared spontaneously in a 9-year-old boy. The second had developed in a 6-year-old girl and was considered to be reactive to prior surgery. The literature is reviewed and data from 16 cases of inflammatory pseudotumor of the bladder in patients under 16 years of age are also presented.The mean age at presentation was 8 years. The male-to-female ratio was 3:1. Hematuria (56%), dysuria (37%) and abdominal pain with a palpable mass (18%) were the most commonly described clinical manifestations. Tumor size ranged from 3 to 10 cm and they were frequently located in the lateral walls and base of the bladder. Histological analysis showed an inflammatory pseudosarcomatous reaction. Immunohistochemical analysis showed moderate staining for vimentin, mild staining for focal muscle actin and negative for keratin and S-100 protein. Patients were treated by local resection (7 pts), partial cystectomy (5 pts), radical cystectomy (2 pts) and pelvic exenteration (2 pts). The mean follow-up was 34 months. All patients that had been followed (14/16) were reported to be free of disease with no evidence of recurrences or metastases.Inflammatory pseudotumor of the bladder is an unusual benign tumor that is very rare in children. Long-term follow-up confirms the benign nature of the lesion and conservative management is therefore advocated. However, given its histological similarity to malignant tumors, a close follow-up is recommended.