Keratoacanthoma of the conjunctiva in a young patient / Ceratoacantoma da conjuntiva em um paciente jovem

ABSTRACT Keratoacanthomas rarely occur in the conjunctiva. We report a case of a 24-year-old man with a rapidly growing conjunctival mass. The tumor was excised with a safety margin to exclude squamous cell carcinoma and was histopathologically diagnosed as a keratoacanthoma. There has been no recurrence over 2 years of follow-up. To the best of our knowledge, he is the youngest patient to be diagnosed with conjunctival keratoacanthoma who had no known risk factors such as skin disorders, trauma, surgery, or infection. In similar cases, we recommend complete early surgical excision and careful follow-up to exclude malignancy.

RESUMO Ceratoacantoma raramente ocorre na conjuntiva. Nós relatamos o caso de um homem de 24 anos de idade, com uma massa conjuntival de rápido crescimento. O tumor foi retirado com uma margem de segurança para excluir carcinoma de células escamosas. Ele foi diagnosticado histopatologicamente como sendo ceratoacantoma. Não houve recidiva em dois anos de seguimento. Ele é o paciente mais jovem com ceratoacantoma conjuntival que não tinham fatores de risco conhecidos como doenças de pele a ser descrito. Em casos semelhantes, recomendamos excisão cirúrgica precoce completo e um acompanhamento cuidadoso para excluir malignidade.

Management of diplopia in patients with blowout fractures.

Purpose: To report the management outcomes of diplopia in patients with blowout fracture. Materials and Methods: Data for 39 patients with diplopia due to orbital blowout fracture were analyzed retrospectively. The inferior wall alone was involved in 22 (56.4%) patients, medial wall alone was involved in 14 (35.8%) patients, and the medial and inferior walls were involved in three (7.6%) patients. Each fracture was reconstructed with a Medpore® implant. Strabismus surgery or prism correction was performed in required patients for the management of persistent diplopia. Mean postoperative follow up was 6.5 months. Results: Twenty-three (58.9%) patients with diplopia underwent surgical repair of blowout fracture. Diplopia was eliminated in 17 (73.9%) patients following orbital wall surgery. Of the 23 patients, three (7.6%) patients required prism glasses and another three (7.6%) patients required strabismus surgery for persistent diplopia. In four (10.2%) patients, strabismus surgery was performed without fracture repair. Twelve patients (30.7%) with negative forced duction test results were followed up without surgery. Conclusions: In our study, diplopia resolved in 30.7% of patients without surgery and 69.2% of patients with diplopia required surgical intervention. Primary gaze diplopia was eliminated in 73.9% of patients through orbital wall repair. The most frequently employed secondary surgery was adjustable inferior rectus recession and <17.8% of patients required additional strabismus surgery.