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@#<p style="text-align: justify;"><strong>Objective.</strong> We present an extremely rare case of primary uveal melanoma (PUM) metastasizing to the intraconal space of the contralateral orbit without involving the liver.</p><p style="text-align: justify;"><strong>Case summary.</strong> This is a case of a 66-year-old woman who underwent enucleation of the right eye for an intra ocular mass five years prior to consult and had a histopathologic diagnosis of spindle cell melanoma. She had no skin lesions nor distant metastasis on systemic work-up. Five years later, she came back for gradual loss of vision in the left eye associated with eye pain and progressive proptosis from a intraconal orbital mass. Excision biopsy of said mass revealed an epithelioid cell melanoma. Again, she has no skin lesions nor liver involvement.</p><p style="text-align: justify;"><strong>Conclusion.</strong> PUM metastasizing to the intraconal space of the contralateral orbit without liver involvement as seen in our patient is exceedingly rare. Despite differences in the histopathologic characteristics, the orbital melanoma was presumed to be metastasis due to the rarity of a second primary and its delayed presentation compared to the PUM.</p>
Subject(s)
Melanoma , Neoplasm MetastasisABSTRACT
Giant cell angiofibroma (GCA) is a recently reported rare soft-tissue tumor that can develop in various sites including orbit. Orbital GCAs were mainly located in the eyelid or extraconal regions such as lacrimal gland and conjunctiva. We report an atypical case of a GCA arising in the intraconal area of the orbit in a 65-year-old male patient. The tumor was excised in total by lateral orbitotomy. Histological and immunohistochemical features were consistent with the diagnosis of GCA. No recurrence was observed during the follow-up of over 2 years. GCA is a rare tumor that should be considered in the differential diagnosis of intraconal orbital tumors. Complete surgical removal is the current optimal treatment option.
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Objective To present the changing of the parameters of orbital volume after endoscopic transethmoid medial orbital wall decompression combined with the endoscopic transethmoid intraconal fat-removal orbital decompression in thyroid associated ophthalmopathy (TAO).Methods A retrospective chart was reviewed in 11 patients (20 eyes) receiving orbital decompression for the treatment of exophthalmos secondary to TAO from September 2014 to August 2015. All patients diagnosed TAO were in stable and inactive phase at least for 6 months. High-resolution computed tomography (HRCT) scan were performed in all patients before and 3-month after surgery. CT scan of orbit and computer-aided measurement software were used to measure the exophthalmos. Changing of the parameters of orbital volume were recorded for analysis its relationship with the amount of proptosis reduction.Results The exophthalmos was signiifcantly decreased after surgery. Medial rectus volume, fat volume and orbital volume were larger postoperatively. The changing of rectus volume and fat volume both had negative correlationship with the amount of proptosis.Conclusions The thickening of medial rectus 3-month postoperative may due to the removing of medial wall of orbit during the surgery. The stimulation of the surgery may be another reason. The changing of rectus volume and fat volume both had negative correlationship with the amount of proptosis.
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Se reporta un caso de fibromatosis orbitaria solitaria en una paciente de sexo femenino de 4 años de edad, la que acudió a consulta por proptosis derecha y pérdida de la agudeza visual. Por tomografía computada (TC), ecografía y resonancia magnética (RM) se identificó una masa intraconal que comprometía a los músculos extrínsecos de la órbita y hacía impronta sobre el nervio óptico.
Solitary fibrous tumor of the orbit. Case report We report on a 4-year-old female patient with solitary fibrous tumor of the orbit, who presented with right eye ptosis and loss of visual sharpness. Computed tomography (CT) scan, ultrasonography (US) and magnetic resonance imaging (MRI) showed an intraconal mass lesion involving the extrinsic orbit muscles, leaving a depression on the aptic nerve.
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PURPOSE: Orbital hematic pseudocyst is the localized accumulation of organized blood-breakdown products within a fibrous capsule, and is known to be typically located subperiosteally. We report a case of orbital hematic pseudocyst in the intraconal space. METHODS: A 51-year-old man visited our clinic, complaining of injection and bruise of his right eye one month before. On the orbit MRI, a mass assumed to be benign was detected in the intraconal space of his right orbit. After several months of follow-up, a decrease of visual acuity and visual field defect were detected in his right eye. Excision of the mass was done through lateral and medial orbitotomy. RESULTS: Histologic examination showed the accumulation of blood-breakdown products within a fibrous capsule, and the mass was diagnosed as a hematic pseudocyst. CONCLUSIONS: When a well-demarcated and slowly growing mass is detected in the intraconal space of the orbit, the possibility of hematic pseudocyst should be considered.
Subject(s)
Humans , Middle Aged , Contusions , Follow-Up Studies , Magnetic Resonance Imaging , Orbit , Visual Acuity , Visual FieldsABSTRACT
Mucormycosis is a relatively uncommon opportunistic fungal infection that occurs more commonly in patients with immunosuppression and diabets mellitus, particularly those with ketoacidosis. Successful therapy for rhinoorbital mucormycosis requires early diagnosis, correction of predisposing conditions, prompt use of amphotericin B, and aggressive surgical debridement. We experienced a 56-years-old poorly controlled diabetic woman with rhinoorbital mucormycosis that was successfully treated with intraconal amphotericin B irrigation and packing without exenteration.
Subject(s)
Female , Humans , Abscess , Amphotericin B , Debridement , Drainage , Early Diagnosis , Immunosuppression Therapy , Ketosis , MucormycosisABSTRACT
Subconjuctival orbital fat prolapse is a disease, which can be diagnosed by clinical manifestations and treated with simple procedure. Intraconal fat prolapses through weakened tenon and protrudes into subconjunctival space. The mass shows convex anterior margin and places at superotemoral region. The mass shrinks when indented and enlarges by putting pressure on the globe. It is frequently seen on males over 60 years old. It usually occurs bilaterally, and does not seem to be in association with obesity. Computer tomography and magnetic resonance image of the orbit show the mass contiguous to intraconal fat. Partial excision with careful hemostasis is sufficient for treatment.
Subject(s)
Humans , Male , Middle Aged , Hemostasis , Obesity , Orbit , ProlapseABSTRACT
Schwannoma(Neurilemoma) is a neoplasm that can occur wherever schwann cells are present, that is, in any myelinated peripheral nerve, brain and sympathetic nerve. Schwannoma tends to occur usually in intraconal area, and it may arise at any point of the orbit, including the lacrimal sac and it may arise at sinus and gasserian ganglion. A 43 years old korean male had painless proptosis, which had developed for 1 month and was dignosed an schwannoma of left orbit. The tumor was excised totally. Histologic examination showed a combination of Antoni type A(dense, cellular) and Antoni type BOoose, edematous or necrotic) patterns.