THE MANAGEMENT OF UNILATERAL EXOPHTHALMOS.
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Disease Management↗
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Results for “ORBITAL NEOPLASMS”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
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Sebaceous gland carcinoma of the eyelid.
We diagnosed sebaceous gland carcinoma of the right lower eyelid in an 82-year-old man. Computed tomography showed the lesion extending from the eyelids anteriorly to the optic foramen posteriorly. With this orbital neoplasm, was an occlusion of the central retinal artery in his right eye. The right orbit was removed surgically and biopsy of the optic foramen region indicated malignant cells. Localized radiation to the right orbit was then initiated postoperatively.
Aged↗
Mortality following exenteration for malignant tumours of the orbit.
BACKGROUND: Orbital exenteration is a rare, but disfiguring procedure reserved for the treatment of locally invasive malignancy or potentially life threatening orbital neoplasms, when less destructive techniques are inadequate. The authors report their experience and analyses of 64 cases of orbital exenteration performed over a 13 year period, looking specifically at key factors affecting mortality associated with such a destructive surgical procedure. METHODS: Records were reviewed retrospectively of all patients who had undergone exenteration of the orbit from 1 January 1991 to 1 April 2004 inclusive, at the Manchester Royal Eye Hospital. In all cases of deceased individuals, the cause of death was determined by liaison with the general practitioner and local health authority. Duplicate death certificates were requested for all deceased patients from the Registrar for Births, Deaths, and Marriages, Southport, UK. Kaplan-Meier analysis was used to estimate survival following exenteration. RESULTS: Overall, 1 year survival post-exenteration was high at 93%. After 3 years this had fallen to 67%, followed by 57% after 5 years, and 37% at 10 years. 13 patients died as a direct result of the orbital tumour. A further nine died of unrelated medical conditions, and two patients succumbed to malignant processes originating elsewhere in the body. There was no difference in survival rate at 3 years (p=0.99) and 5 years (p=0.454) between those with clear resection margins and those without. CONCLUSION: In this study it was found that there was an overall mortality rate of 38% over 12 years. The presence of clear surgical margins, although reassuring for the surgeon, should not be regarded as an indication of cure. However, an overall 1 year survival of 93% and a 10 year survival of 37% are reassuring in that a proportion of individuals achieve surgical cure following exenteration. 38% of patients died as a result of other medical causes over the 12 year follow up.
Adolescent↗
Orbital tumors.
Neoplasms involving the orbit are divided into primary and secondary types. Primary orbital tumors are rare, include a wide variety of histopathologic types, are usually benign, and most often are managed surgically. Secondary orbital tumors are most often malignant, arise from the paranasal sinuses, and are managed with multiple modalities in a planned fashion. This article discusses primary and secondary orbital tumors, including their evaluation and management.
Humans↗
Metastatic gastroesophageal junction adenocarcinoma to the extraocular muscles.
OBJECTIVE: To present one definitive and one probable case of gastroesophageal adenocarcinoma metastases to the extraocular muscles. DESIGN: Two observational case reports. METHODS: Two interventional case reports with clinical pathologic correlation and review of the literature. Vanderbilt University Institutional Review Board approval was obtained for this report. MAIN OUTCOME MEASURES: We analyzed the presenting symptoms, visual acuity, motility, and external examination. RESULTS: Computed tomography showed nodular enlargement of an isolated rectus muscle. Histopathologic examination confirmed the diagnosis of metastatic gastrointestinal carcinoma in one case. The orbital neoplasm contained signet ring cells, classically seen in gastrointestinal malignancy. CONCLUSIONS: Metastasis from gastrointestinal carcinoma should be considered in the differential diagnosis of a patient presenting with diplopia or visual loss, particularly with a recent history of gastrointestinal malignancy.
Adenocarcinoma↗
LOCALLY MALIGNANT AND RADIORESISTANT TUMORS OF THE FACE.
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Adenocarcinoma↗
Usefulness of sagittal computed tomography in neurosurgery.
Sagittal section tomographic images can be obtained either directly or by an electronic reconstructing procedure. These two techniques are extremely useful for neurosurgeons because it is possible to obtain a better clinical and pathological evaluation of the lesion. This procedure is almost recommended in case of pituitary adenoma, cerebello-pontine angle neoplasms, orbital lesions and brain-stem lesions. The authors show the results of the experience of the University of Pavia and discuss the true indications to this neuroradiological technique.
Adenoma↗
Tumours of the orbit diagnosed by fine needle biopsy.
Fine needle aspiration biopsies were used for the diagnosis of orbital tumours. Examples of benign and malignant primary and metastatic orbital neoplasms, as well as inflammatory lesions diagnosed in this way are described. The method has proved of great value. This was specially true for processes located posteriorly in the orbit. The necessity for close cooperation between the ophthalmological and clinical cytological departments is emphasized.
Adult↗
Combined positron emission tomography/computed tomography imaging of orbital lymphoma.
PURPOSE: To report a case of orbital lymphoma with systemic dissemination that was identified and localized by combined positron emission tomography (PET)/computed tomography. DESIGN: Case report. METHODS: A 75-year-old woman presented with a 6-month history of painless, progressive fullness of her right upper eyelid. A PET/computed tomography was obtained to provide functional and anatomic assessment of the orbits. An orbitotomy was performed with sub-total excision of the lesion to obtain histologic diagnosis. RESULTS: The PET/computed tomography scan revealed intensive uptake of tracer in a right orbital mass measuring 2.3 x 1.8 x 2.6 cm. Foci of abnormal tracer uptake were also noted in the right neck, right hilar region, and central abdomen. Histopathologic findings were consistent with follicular cell lymphoma. CONCLUSIONS: The combination of PET/computed tomography provides accurate and precise information in an expedited manner not offered by alternative imaging modalities. PET/computed tomography imaging should be considered in the evaluation of orbital neoplasms, especially if lymphoma is suspected.
Aged↗
[2. Diagnostic resources and clinical indications].
Preliminary investigations, dedicated to the diagnostic application of three-dimension ultrasonic angioreconstruction, confirmed the feasibility of using the above method in ophthalmologic practice in cases of suspected intraocular and orbital neoplasms. 32 patients (37 eyes) with various pathologies of the eye and orbital cavity, including choroidal melanoma, facial angiomatosis, retinal detachment, chronic uveitis etc.) were examined. The results are indicative of that the three-dimension ultrasonic angioreconstruction makes it possible to detect the latent vascular neoplasms, which cannot be defined by the standard visual and ultrasonic examinations, and the dislocation of structural elements of the eyeball tunics. Besides, it provides for evaluating their special localization and their interrelations with the neighboring anatomic elements.
Adolescent↗
Orbital fine needle aspiration biopsy with B-scan guidance.
In three patients we used B-scan ultrasonography to guide the placement of an aspirating needle, which allowed rapid and accurate cytologic diagnosis of retrobulbar orbital neoplasms. This technique spares the patient the greater costs, inconvenience, and morbidity of more invasive procedures.
Aged↗
[APROPOS OF A PERILACRIMAL TUMOR].
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Humans↗
Expanding MIRAgel scleral buckle simulating an orbital tumor in four cases.
PURPOSE: To describe four patients with an enlarging orbital mass from a swollen MIRAgel scleral buckle that simulated an orbital neoplasm. METHODS: In a retrospective, single-center case series at the Ocular Oncology Service at Wills Eye Hospital of Thomas Jefferson University, 4 eyes of 4 patients were referred for evaluation and treatment of a suspected orbital tumor. RESULTS: The initial presenting features were orbital mass (case 1), strabismus (case 2), and conjunctival mass with orbital extension (cases 3 and 4). Each patient vaguely recalled previous uncomplicated retinal detachment surgery 12 to 20 years earlier. Confirmation of the buckling implant material was made with the retina surgeon in 3 cases. A nontender, forniceal conjunctival mass, deep to the Tenon fascia and appearing as a translucent firm elevation was seen in all 4 cases. Axial CT (case 1) revealed a circumscribed anterior temporal orbital mass, believed to be a large inclusion cyst, 4 times thicker than the nasal scleral buckle. Ocular ultrasonography depicted an echolucent mass in the episcleral region (cases 3 and 4) that was 2 times thicker than the nasal scleral buckle (case 3). Excision was attempted in case 1, but only piecemeal removal was achieved, leading to extensive postoperative inflammation and decreased vision. The other 3 cases were followed conservatively without excision because they were each recognized to be a swollen MIRAgel implant and not an orbital tumor. CONCLUSIONS: MIRAgel scleral buckle material can greatly enlarge over a period of 10 years and simulate an orbital tumor or orbital cyst. Patients often do not recall details of the retinal surgery. Caution is advised regarding excision of this material because it is friable and can lead to extensive postoperative inflammation.
Adult↗
Lateral extensions of the Müller muscle.
OBJECTIVES: To define the lateral extension of the Müller muscle and to elucidate its involvement in the development and surgical treatment of Graves (thyroid) eye disease. METHODS: Twelve lateral halves of orbits exenterated from patients with medial or posterior orbital neoplasms were fixed, embedded, and step sectioned at 250-microns intervals to produce histological sections. Gross anatomical dissections of human cadaver heads were also used to corroborate the histological findings. RESULTS: Histological analysis revealed that the Müller muscle extended laterally between the orbital and palpebral lobes of the lacrimal gland in all specimens. The smooth muscle fibers were found to interdigitate with lacrimal ducts passing from the orbital to palpebral lobe and to extend close to the ductal orifices at the conjunctival surface. Gross dissections confirmed that the Müller muscle accompanied the levator aponeurosis lateral extension, which is known to pass between the orbital and palpebral lobes of the lacrimal gland. CONCLUSIONS: Our anatomical findings suggest that the Müller muscle may contribute to the temporal flare frequently seen in eyelid retraction associated with thyroid eye disease. They may also explain the difficulty of treating lateral eyelid retraction in thyroid eye disease and indicate the need for new surgical approaches for severe lateral eyelid retraction.
Eye Enucleation↗
Orbital ganglioglioma arising from ectopic neural tissue.
PURPOSE: To report a case of neonatal orbital ganglioglioma originating from ectopic neural tissue. METHOD: Case report. RESULTS: An African-American male presented at birth with proptosis and expansion of the left orbit. A discrete soft-tissue mass was located inferolateral to the globe, which proved to be a ganglioglioma. CONCLUSION: The tumor is presumed to have originated from ectopic neural tissue in the orbit. Although infrequent, this tumor should be included in the differential diagnosis of neonatal orbital neoplasms.
Brain↗
[Histological changes in the human cornea following roentgen irradiation. I].
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Cornea↗
Tumors metastatic to the orbit: a changing picture.
Clinical characteristics of tumors metastatic to the orbit are related to primary tumor biology, and vary substantially among the various primary types. Common known primary sites include breast, lung, prostate, and melanoma. Tumor presentations can be classified into four generalized syndromes of mass, infiltrative, inflammatory, and functional effects. We found the infiltrative syndrome of presentation to be more common than for other types of orbital neoplasm. Accurate diagnosis often depends on recognition of the types of clinical syndromes and on the use of diagnostic modalities such as computed tomography, magnetic resonance imaging, fine needle aspiration biopsy, and open biopsy. Special histologic techniques are often useful in determining the origin of these often poorly differentiated tumors, and can provide a basis for specific hormonal therapy. Ophthalmologists play a vital role in the diagnosis of metastatic cancer; the orbital tumor was the presenting sign of systemic cancer in 42% of the cases reviewed. Although the overall prognosis for patients with metastatic cancer is quite poor, specific therapy is available for a growing number of cancers. Timely intervention based on accurate diagnosis can dramatically improve the duration and quality of life with selected tumors.
Aged↗
[MALT lymphoma of the orbit].
MALT lymphomas of the orbit are rare orbital tumors; the differential diagnosis needs to exclude inflammatory pseudotumors of the orbit, but also benign lymphoproliferations, pseudolymphomas, and other orbital neoplasms. After histological confirmation of the diagnosis staging is necessary, and - as long as the disease is localized exclusively in the orbit - radiation therapy should be started. The clinical picture of MALT lymphoma and its differential diagnosis and treatment are discussed with reference to an actual case.
Aged↗