摘要:

SummaryWe describe a case of basal cell carcinoma (BCC) situated on the external upper margin of the right eyelid in a young man aged 28 years. The tumor was diagnosed as an “extended wart in a degenerative phase” and removed during reconstructive plastic surgery. No pathologic examination was performed. Seven years later, the operation was followed by a first recurrence. Pathologic examination was then performed, and the diagnosis was BCC. Therapy was with radiotherapy and chemotherapy. Subsequent recurrences were treated with radiotherapy and surgery (enucleation, exenteration of the orbit), but the evolution of the tumor was not halted. It ended 25 years after its first manifestation with the death of the patient of a hemorrhage of the upper airways during an operation, the aim of which was to reexamine the orbital cavity. The autopsy revealed intracranial extension of the tumor, and all the histological examinations confirmed the diagnosis. No histopathological feature was found that could differentiate a particularly aggressive nature of the tumor. Basal cell carcinoma is a tumor more frequently encountered in elderly patients. Its appearance in a young subject may cause grounds for suspicion, requiring initial radical surgical treatment and careful surveillance of the evolution of the lesion. This case documents the fatal consequences that may arise from the failure to recognize BCC in its first manifestation and highlights the ineffectiveness of repeated radiation and surgical therapy against continual recurrence.

ISSN:0740-9303    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

SummarySolitary fibrous tumor (SFT) of the orbit is a very rare lesion that may be misdiagnosed as fibrous histiocytoma, hemangiopericytoma, or other orbital tumors. We present a 62-year-old man who presented with painless proptosis, 20 years following left eye enucleation for a presumed neurofibroma. On T2-weighted magnetic resonance imaging (MRI), a hypointense tumor almost filled his entire left orbit. There was no intracranial extension. The specimen obtained at orbital exenteration was consistent with the histologie, immunohistochemical, and electron microscopic findings of SFT. The tumor was positive for vimentin and CD34 staining but negative for S-100 protein and epithelial membrane antigen. Only nine other cases of SFT of the orbit have been documented in the literature. Recognition of SFT of the orbit as a distinct pathologic entity and further follow-up of published cases are needed to determine the prognosis of this rare lesion.

ISSN:0740-9303    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

SummaryOsteosarcoma is a common primary bone malignancy most often involving the long bones and occurring in the second decade of life. Orbital involvement in this disease process is rare and is usually due to extension of the tumor from an adjacent sinus cavity. Orbital osteosarcoma arising from preexisting Paget disease is exceedingly rare. We report the case of a 78-year-old female patient with Paget disease of the forehead who presented with rapidly increasing bilateral proptosis and visual loss for several months. Examination showed bilateral aphakia, decreased motility, proptosis with resistance to retropulsion, and tumorous infiltration of the eyelids and periorbital soft tissue. Fundus examination showed marked bilateral scierai indentation without overlying serous retinal detachment. A computed tomographic (CT) evaluation of the orbits demonstrated extensive soft tissue involvement of the paranasal sinuses, nasal cavity, periorbital soft tissue, and orbits, with compression of the optic nerve and globe bilaterally. Biopsy of the periorbital soft tissue demonstrated osteosarcoma. Radiation therapy failed to stem the progression of the disease process, and the patient died ∼4 months later. Although osteosarcoma of the orbit associated with Paget disease is unusual, it should be considered in the differential diagnosis of older patients with a rapidly progressive orbital mass.

ISSN:0740-9303    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

SummaryMultiple myeloma is a plasma cell malignancy often associated with destructive skeletal lesions. Orbital involvement in multiple myeloma is rare. Risk factors for orbital involvement have not been established, although risk may vary with immunoglobulin subtype. Early detection of orbital plasmacytoma may affect treatment and clinical course. A case is reported of multiple myeloma without elevated serum immunoglobulins that involves the orbit, and the implications of early detection are discussed. The patient was first examined by an ophthalmologist 13 months after multiple myeloma was diagnosed and 5 months after the external appearance of an orbital tumor. Urine protein electrophoresis demonstrated kappa light chains. Hypergam-maglobulinemia was not detected. Plain-film roentgenography showed orbital involvement at the time of initial diagnosis. An impressive clinical response to external beam radiation therapy was seen. Attention to immunoprotein characteristics in multiple myeloma may help to identify risk factors for orbital involvement. Early detection may permit safer and equally effective treatment. All patients with multiple myeloma should undergo thorough ophthalmic examination at the time of initial diagnosis.

ISSN:0740-9303    

出版商:OVID    

年代:1998

数据来源: OVID