From Scalpel to Syringe: Intralesional Interleukin-2-Based Therapy is Effective for Locally Advanced Periocular Cutaneous Squamous Cell Carcinoma

Cutaneous squamous cell carcinoma (cSCC) is a common eyelid malignancy that is typically treated by surgical excision. Locally destructive periocular cSCC may not be amenable to surgery in cases where extensive resection would result in structural or functional compromise.

We report the first series of biopsy-confirmed periocular cSCC cases treated with intralesional interleukin-2 (IL-2)-based therapy.

Treatment courses for five patients are summarized, with one representative case detailed here. A 74-year-old man presented with a large, painful, centrally pedunculated mass on the left upper eyelid, measuring 5.5 cm by 2.5 cm. Mass excisional biopsy and reconstruction revealed moderately differentiated invasive SCC involving deep and peripheral margins. Given the risks associated with further resection, the patient opted to pursue local immunotherapy. He received five doses of intralesional IL-2 every 2 weeks. The lesion was completely clinically cleared at 6 weeks, and there was no recurrence noted at 15-month follow-up.

Local intralesional IL-2-based therapy may be a treatment option for periocular cSCC in cases that may result in significant functional or aesthetic compromise, or in those who have failed prior standard of care.