Clinical Experience of Foreign Body Granuloma in the Apex of Orbit

It is often difficult to identify and localize intraorbital foreign bodies despite of modern high-resolution imaging investigation. Especially, posteriorly located foreign bodies have increased risks of morbidity that surgical approach is often complicated. No matter how trivial it seems, retained foreign body, particularly organic in nature, may give rise to severe orbital and cerebral complications. High clinical suspicion, proper diagnostic studies, timely referral to a skilled orbital surgeon are mandatory. We report a case of intraorbital wooden foreign body that required two separate exploration for removal. Initial exploration failed to identify and locate the foreign body completely. After the operation, fistula formation and purulent discharge were developed and the imaging investigation results were equivocal, complicating the management. A second exploration yielded multiple intraorbital wooden foreign body in the apex of orbit. The patient fully recovered without complication. The evaluations and the details of management strategy are discussed.

A Case Report: Fibrous Hamartoma of Infancy in the Buttock

Fibrous hamartoma of infancy is an uncommon, benign, subcutaneous fibrous proliferation and usually found during the first 2 years of life, presenting non- tender, hard and movable soft-tissue mass. This tumor can cause much concern about malignancy because it may be fixed in the underlying tissue and is composed of poorly differentiated mesenchymal cells. The diagnosis is made easily by the characteristic histologic features, treatment is local excision and the prognosis is excellent. Because misdiagnosis of malignancy can lead to unnecessary radical therapy, both surgeon and pathologist must be aware of this entity. We experienced and report a case of a 11 month-old male patient who had a 10x15 cm sized hard, fixed and non-tender mass on the right buttock that manifested characteristic pathology of this disease. We excised the mass widely with safety margin of 1 cm and no recurrence was reported in 12 months.

The Usefulness of Nasal Bone CT in Diagnosis of the Nasal Bones Fractures of Children

The incidence of nasal bone fracture in children is relatively uncommon compared with that in adults. But nasal injuries in children merit special attention, because the disturbance of the growth centers essential to the normal development may cause significant cosmetic or functional disabilities, the patients should be carefully examined and properly treated. Because the injured nose swells more quickly and more diffusely in children than in adults, the diagnosis is more difficult. The pediatric patient does not permit even the most gentle examination at times and x-ray examination is often inconclusive. Because of these reasons, the diagnosis of nasal fractures in children is often difficult. The authors have performed facial bone CT in accurate diagnosis of the nasal bones fractures in such children. Conclusively, facial bone CT is useful in early accurate evaluation of the nasal bones fractures in children.

Cranial Fasciitis: Presentation as a Temporal Mass

Cranial fasciitis is a rare morphological variant of nodular fasciitis. It is characterized by a rapid growing fibroblastic proliferative lesion that develops chiefly in childhood. It has varying size and involves the soft tissues of the scalp and the underlying skull. Accurate diagnosis and surgical excision is the key to management. Prognosis is good with rare recurrence. We report a case of cranial fasciitis in the temporal fossa of a 20-month-old girl and present a review of the literature.