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Biomedical subjects

M Halhal

Publications and source records attributed to M Halhal.

At least 37 records · Page 2Linked to original sources

[Bilateral keratoconus: a case report].

Among corneal dystrophies, the keratoconus is one of the most frequently observed among young adults. A clinico pathological case is reported in a 13-year-old-girl of African origin. The diagnosis of bilateral keratoconus was established based on the obvious changes of the corneal curvature and thickness. After an unsuccessful attempt to improve vision with contact lenses, a keratoplasty was finally performed on one side to remove the pathological cornea. Its histopathological study found the characteristic changes of keratoconus: breaks of Bowman's layer and corneal thinning.

Adolescent↗

[Inflammation of an ectopic pinguecula].

An 80-year-old male patient experienced recently diagnosed swelling of the limbal conjunctiva. In his clinical history were found cataract surgery on the right eye 3 months before, chronic open angle glaucoma effectively treated by local eye drops, treated systemic hypertension and hypercholesterolemia. On ophthalmic examination, a conjunctival mass was present in the inferior lateral conjunctival quadrant next to the limbus, with numerous vessels visible at its top. Treatment with topical corticosteroids failed to obtain regression, but decreased the local inflammatory signs. The persistence of the mass led to its surgical excision under local anesthesia. Histopathology found a subepithelial accumulation of modified collagen bundles typical of elastotic degeneration. Capillary vessels were seen in the superficial subepithelial area, attesting to the high degree of vascularization observed clinically. The final diagnosis was a pinguecula, which was not exactly located on the horizontal meridian area as it is usual.

Aged↗

[Actinic keratosis seborrheic wart and nevus: three distinct cutaneous eyelid skin lesions in a single patient].

A 67-year-old woman had three different tumors of the eyelids. The most prominent one was a nevus of the free margin of the inferior left eyelid. The nevus was followed for 18 months without change while two epidermal papillomatous tumors grew and were surgically removed. Histopathology disclosed that one tumor was a seborrheic keratosis and the other was a pre-epitheliomatous keratosis. Histologic evaluation of the margins showed that surgical removal was complete. A regular examination of the scars was recommended to the patient.

Aged↗

[Neovascular glaucoma following proton-beam therapy. Case report].

A 52-year-old-male patient was treated for a posterior choroid melanoma of the right eye. When it was diagnosed, it measured 6mm in thickness and 11.9mm for the largest diameter and had a typical mushroom shape. General investigations found no metastatic disease. It was treated with proton-beam irradiation. Seven years later, the patient experienced increased intraocular pressure associated with cataract and pain. The patient finally accepted enucleation, as the vision of this eye was completely lost and the eye had become painful. Histologic analysis of the eye showed changes affecting both the anterior and the posterior segments of the eye, mostly related to the tumor and the consequences of treatment. Neovascular glaucoma is a major complication that very often leads to enucleation.

Cataract↗

[Orbital lymphangioma. A case report].

The diffuse form of orbital lymphangioma is well known for its difficult surgical treatment. A diffuse orbital lymphangioma was diagnosed in a 6-year-old girl, revealed by unilateral recurrent proptosis. The imaging procedure discovered a mass presumed to be vascular in nature. The initial incompleted surgical removal was followed by 3 recurrences motivating 3 reoperations. Finally, the tumor was removed incompletely, with an acceptable reduction of the proptosis. The pathologic analyses indicated lymphangioma. Some vascular orbital tumors such as lymphangioma, may be very difficult to manage because of local spreading and frequent recurrence.

Adolescent↗

[Papillomatous and nevus of the caruncle].

A 63-year-old male patient was operated of a single conjunctival papillomatous lesion located on the left caruncle. The curative tumoral excision was followed by its histological analysis. Histologically, the tumor associated an epithelial squamous papilloma with a subepithelial nevus, confirming a combination of two different lesions.

Conjunctiva↗

[Conjunctival in situ carcinoma in a patient with Waldenström's disease].

A 73-year-old male patient was treated for conjunctival in situ carcinoma invading the cornea of his right eye. The patient had been previously operated on for two corneoconjunctival lesions on the same eye (one was a pterygium, the other was simple epithelial hyperplasia) and was regularly followed for a systemic lymphoplasmocytic lymphoma (Waldenström's disease). After a corneoconjunctival excision of the tumor, the histological analysis was performed and established the diagnosis of in situ carcinoma. The tumor recurred a few months later and radiation therapy was then given. No recurrence was observed after this latter treatment.

Aged↗

[Tuberculous uveitis].

Ocular tuberculosis is relatively rare; however, the most common ocular lesion during ocular tuberculosis is uveitis. The recrudescence of this disease is probably caused by human immunodeficiency virus or long-term corticotherapy. The authors report a of chronic unilateral tuberculosis-related uveitis complicated by panophthalmia with subconjunctival abcesess and scleral fistula. A histopathological study revealed a granulomatous inflammation with caseous material. An extensive work-up revealed no extraocular lesion. A systemic bactericidal treatement associated with topical steroids decreased the local inflammation with phthisis bulbi, and with no spread of the infection. The authors discuss the etiopathogenic, clinical, and therapeutic aspects of tuberculosis-related uveitis.

Adult↗

[Uveal effusion in its pseudotumoral form. A case report].

Uveal effusion exhibits various clinical presentations, some of which may lead to erroneous diagnosis and mimic a choroidal tumor. A 73-year-old female patient displayed a choroidal lesion with a tumoral appearance spontaneously affecting her right eye. Ultrasonography did not establish the diagnosis, leaving doubt for a tumor. In addition to the tumor - like lesion, a moderate inflammation was found in her right eye. The clinical course was favorable and one month after the initial examination, no fundus abnormalities were observed. The delay imposed by the MRI examination contributed to the lack of any active treatment. Apart from cases occurring postoperatively, the diagnosis of uveal effusion may sometimes be difficult to establish. In order to avoid enucleation and even if ultrasonography is helpful in reaching the correct diagnosis, it seems appropriate to wait and regularly follow up the patients when the diagnosis is not certain. The clinical course might be helpful to establish the diagnosis. Our case suggests that in pseudotumoral forms of uveal effusion, we should repeat clinical examination and ultrasonography in order to manage these patients appropriately.

Aged↗

[Orbital wooden foreign body].

A 76-year-old-female patient fell in her garden, inducing a right orbital wound in which no foreign body was primarily found. As pain and diplopia followed the orbital trauma, a CT-scan was performed, disclosing a linear external foreign body in the right orbit. An anterior orbitotomy was performed to remove an 18-mm-long wooden foreign body. Histopathology of the tissue surrounding the foreign body showed an inflammatory fibrous tissue with small granulomas around telluric particles. Improvement after the operation was dramatic with complete disappearance of diplopia the day following surgery. Antibiotics were prescribed and tetanus prophylaxis was performed.

Accidental Falls↗

[Hyperkeratosis papilloma of the eyelid. An anatomic clinical case].

A clinicopathologic case of an 80-year-old male patient with a single cutaneous tumor on the upper part of the left eyelid is reported. It was a grayish and pigmented mass covered with a thick keratin layer, well circumscribed, and exophytic. After surgical removal, histopathology showed that the tumor had a papillomatous pattern and was growing under a thick layer of hyperkeratosis. It was a typical squamous cell papilloma. This tumor belongs to the benign eyelid tumor group and can be found on the eyelids of elderly people.

Aged↗

[Iridocorneal endothelial syndrome. Series of 7 cases].

The ICE syndrome includes 3 variants of the same disease, previously believed to be independent entities. All 3 share clinical and histopathological features such as endothelial abnormalities, iris damage, and progressive closure of the iridocorneal angle. Seven cases of ICE syndrome are reported, affecting 6 women and 1 man, with a mean age of 40 years. Corectopia was found in 5 eyes, a uveal ectropion in 2 cases, and other iris changes in 3 cases. The endothelial changes of the cornea were confirmed by a speculum microscopy in 5 cases. There were 5 cases of Chandler syndrome, 1 of Cogan-Reese syndrome, and 1 case of iris essential atrophy in our series. Ocular hypertony was observed in 3 cases, 2 of which needed to be operated. In one patient, a corneal edema was observed.

Adult↗

[Epithelial cyst in the superior internal angle: a case report].

Most orbital cysts in childhood are epidermoids or dermoids. We report one uncommon case of an 8-years old girl with a lacrimal orbital cyst revealed by discrete proptosis and pseudo-ptosis in which the cystic histopathological study revealed a lacrimal structure.

Child↗

[Limbal dermoid and Goldenhar syndrome. Report of an anatomoclinical study].

Dysembryoplastic neoplasm, the limbal dermoid is a benign congenital tumor involving the outer coat of the eye. This congenital tumor affected the right eye of a 6-year-old girl. The lesion was typically hemispheric, covered with pink skin, located in the inferior and temporal part of the cornea, and devoid of any major consequences except the cosmetic appearance of the eye. There were no other major abnormalities in the clinical examination but a single skin tag could be observed at the homolateral preauricular area without any visible cutaneous fistula next to it. This additional change allowed us to establish the diagnosis of a minor form of Goldenhar syndrome. This malformative syndrome typically includes several changes: dermoid and/or dermolipoma, preauricular tags and/or cutaneous fistulas in the same area, vertebral abnormalities etc. These findings may be limited to dermoid and cutaneous tags, as in our report. Such changes must be looked for in all limbal dermoids.

Child↗

[Meibomian adenocarcinoma of the free palpebral edge. Report of a case].

A case of meibomian carcinoma of the left eyelid is reported in a 72-year-old female patient. The tumor had been present on the left eyelid for months. Clinically, the tumor appeared as a reddish mass implanted on the external part of the free margin of the left superior eyelid. An excisional biopsy disclosed meibomian carcinoma. A total resection of the left superior eyelid was followed by plastic surgery. Results after a one-month follow-up were very satisfactory. This case is emphasizes the importance of an early diagnosis which enabled us to perform a rather conservative treatment limited to the removal of the affected eyelid. The diagnosis of meibomian carcinoma is infrequent but it must be kept in mind in cases of tumor without the typical clinical characteristics of a basal cell or squamous cell carcinoma. Complete removal surgery may bring a curative effect and histopathology has a key role in the diagnosis of meibomian carcinoma.

Adenocarcinoma↗

[Large basal cell carcinoma of the external palpebral angle].

A clinicopathologic case of an 89-year-old female patient with a single cutaneous tumor at the outer part of the outer left eyelids is reported. It was a pink nodular mass, well circumscribed, exophytic and with thin vessels. After surgical removal, histopathology showed that the tumor was a typical basal cell carcinoma, with many cystic-like cavities. Basal cell carcinomas can be commonly observed on the eyelids and surgical excision of these small size lesions is an easy way to perform a curative treatment. As often in other tumors, early diagnosis is probably the easiest way to improve the prognosis.

Aged↗

[Endonasal dacryocystorhinostomy (DCR) with protected drill].

PURPOSE: To analyze the interest of protected drills to perform endoscopic endonasal DCR. MATERIAL AND METHODS: [corrected] Fifty patients suffering from chronic epiphora were operated successively. None of those patients had had prior nasal surgery. The same surgeons (BF and ER) did the surgical procedure for all the cases. The technical steps were: endoscopic visualization of the middle meatus and evaluation of the anatomic variations of the nose; identification of the lacrymal bag with a 1 mm light in the canaliculus; unciformectomy; the maxillary bone was drilled with a 3.2 mm bit (straightshot Xomed), protected and irrigated; the lacrymal bag was opened by cissors and the flap was pushed in the ethmoid and coagulated. RESULTS: The suction-irrigation system was efficient to clean the surgical site, with a good endoscopic control. The protected bit didn't damage the 4-mm optics and the septal wall mucosa, even in narrow noses. The staightshot bit (Xomed) was tough enough to drill the maxillary bone in only 68 % of the surgical cases. In 28 % the drilling was unsatisfactory and in 4 % it was inefficient. The functional results at 6 month were good in 85 %. There was no difference between normal and narrow noses. CONCLUSION: The concept of protected bits perfectly matches the endoscopic endonasal DCR. The visual comfort and security of the surgical procedure are increased. Short term results are equivalent to external DCR, but are rather inefficient and expensive.

Chronic Disease↗