Reconstrucción de párpado inferior mediante injerto de pericráneo y colgajo de Mustardé / Lower eyelid reconstruction with pericranium graft and Mustarde flap

Varón de 68 años que acude para valoración de un carcinoma basocelular con diferenciación escamosa en el párpado inferior izquierdo. Se realizó una resección con control de margen de sección congelada y el defecto (canto interno, dos tercios del párpado inferior y 2,5cm de la mejilla) fue reconstruido 2 días después de la cirugía en un solo acto quirúrgico: la lamela posterior con injerto de pericráneo y la anterior con un flap de Mustardé. Después de un año de seguimiento, el paciente tiene un aspecto aceptable, un buen soporte y posición palpebral, tejido vascularizado como el nativo en el párpado, sin recurrencia del tumor

We report the case of a 68-year-old man with a left lower eyelid basal cell carcinoma with squamous differentiation. Resection was performed under frozen section technique and the defect (inner canthus, two thirds of the lower eyelid and 2.5cm of the cheek) reconstructed 2 days after surgery in a single surgical operation: posterior lamella with pericranial graft and anterior lamella with Mustarde flap. After one year of follow-up, the patient has an adequate appearance, good eyelid support and position, vascularized tissue like the native eyelid and no tumor recurrence

Lower eyelid reconstruction with pericranium graft and Mustarde flap. / Reconstrucción de párpado inferior mediante injerto de pericráneo y colgajo de Mustardé.

We report the case of a 68-year-old man with a left lower eyelid basal cell carcinoma with squamous differentiation. Resection was performed under frozen section technique and the defect (inner canthus, two thirds of the lower eyelid and 2.5cm of the cheek) reconstructed 2 days after surgery in a single surgical operation: posterior lamella with pericranial graft and anterior lamella with Mustarde flap. After one year of follow-up, the patient has an adequate appearance, good eyelid support and position, vascularized tissue like the native eyelid and no tumor recurrence.

Sarcoma de Kaposi palpebral bilateral en un paciente virus de la inmunodeficiencia humana negativo / Bilateral eyelid Kaposi's sarcoma in an HIV-negative patient

CASO CLÍNICO: Un varón de 70 años, procedente de Sicilia, acude con una masa palpebral bilateral con afectación tarsal conjuntival, que resultó ser un sarcoma de Kaposi al examen histológico. Se demostró afectación cutánea y pulmonar por el sarcoma de Kaposi. El paciente no tenía un diagnóstico previo de infección por el virus de la inmunodeficiencia humana. Este caso fue tratado con éxito tras 5 ciclos de quimioterapia con doxorrubicina liposomal, con resolución de las lesiones palpebrales, cutáneas y pulmonares. Conclusiones: La localización en el párpado es una posible manifestación inicial, aunque rara, del sarcoma de Kaposi en personas de edad avanzada negativos para el virus de la inmunodeficiencia humana. La doxorrubicina liposomal es un tratamiento seguro y efectivo

CASE REPORT: We report a case of 70-year-old male from Sicily, who presented with a bilateral eyelid mass involving the tarsal conjunctiva, found to be Kaposi's sarcoma on histologic examination. Cutaneous and pulmonary Kaposi's sarcoma involvement was documented. The patient had no prior diagnosis of human immunodeficiency virus infection. This case was managed successfully after the completion of five cycles of chemotherapy with liposomal doxorubicin, and his eyelid, skin and pulmonary lesions disappeared. CONCLUSIONS: Location in the eyelid is a possible, though rare, initial solitary manifestation of Kaposi's sarcoma in elderly HIV-negative patients. Liposomal doxorubicin is a safe and effective treatment

Bilateral eyelid Kaposi's sarcoma in an HIV-negative patient. / Sarcoma de Kaposi palpebral bilateral en un paciente virus de la inmunodeficiencia humana negativo.

CASE REPORT: We report a case of 70-year-old male from Sicily, who presented with a bilateral eyelid mass involving the tarsal conjunctiva, found to be Kaposi's sarcoma on histologic examination. Cutaneous and pulmonary Kaposi's sarcoma involvement was documented. The patient had no prior diagnosis of human immunodeficiency virus infection. This case was managed successfully after the completion of five cycles of chemotherapy with liposomal doxorubicin, and his eyelid, skin and pulmonary lesions disappeared. CONCLUSIONS: Location in the eyelid is a possible, though rare, initial solitary manifestation of Kaposi's sarcoma in elderly HIV-negative patients. Liposomal doxorubicin is a safe and effective treatment.

A propósito de un caso de hamartoma retiniano adyacente a cabeza de nervio óptico en un caso de esclerosis tuberosa / Peripapillar retinal hamartoma associated with tuberous sclerosis. Case report

Introducción: La esclerosis tuberosa es una enfermedad multisistémica rara, con un patrón de herencia autosómico dominante. Existen pocos casos documentados en la literatura de hamartomas retinales (astrocitomas) con progresión agresiva en el contexto de esta enfermedad. Caso clínico: Se presenta el caso de un varón de 31 años sin antecedentes de afecciones oftálmicas ni sistémicas conocidas, que refirió una historia de 6 meses de visión borrosa en el ojo derecho causada por un hamartoma unilateral de retina, en un caso no diagnosticado de esclerosis tuberosa. Discusión: Es necesario realizar un manejo multidisciplinario, con la colaboración del Departamento de Medicina Interna y de Oncología, así como ofrecer asesoramiento genético para los pacientes afectados. Las complicaciones están directamente relacionadas con el aumento del tamaño del tumor. El tratamiento no parece tener ninguna influencia en la historia natural de la enfermedad (AU)

Introduction: Tuberous sclerosis is a rare multisystemic disease with an autosomal dominant inheritance pattern. There are few documented cases in the literature of retinal hamartomas (astrocytomas) with aggressive progression in the context of this disease. Case report: A report is presented on a case of a 31 year-old male with unknown history of ophthalmic or systemic conditions, who referred to a history of 6 months of blurred vision in his right eye. This was caused by a unilateral retinal hamartoma due to an undiagnosed tuberous sclerosis. Discussion: Multidisciplinary management, with the cooperation of Internal Medicine and the Oncology Department, is needed in these cases, as well as genetic counselling for affected patients. Complications are directly related to increased tumour size. Treatment does not seem to have any influence on the natural history of the disease (AU)

Peripapillar retinal hamartoma associated with tuberous sclerosis. Case report. / A propósito de un caso de hamartoma retiniano adyacente a cabeza de nervio óptico en un caso de esclerosis tuberosa.

INTRODUCTION: Tuberous sclerosis is a rare multisystemic disease with an autosomal dominant inheritance pattern. There are few documented cases in the literature of retinal hamartomas (astrocytomas) with aggressive progression in the context of this disease. CASE REPORT: A report is presented on a case of a 31 year-old male with unknown history of ophthalmic or systemic conditions, who referred to a history of 6 months of blurred vision in his right eye. This was caused by a unilateral retinal hamartoma due to an undiagnosed tuberous sclerosis. DISCUSSION: Multidisciplinary management, with the cooperation of Internal Medicine and the Oncology Department, is needed in these cases, as well as genetic counselling for affected patients. Complications are directly related to increased tumour size. Treatment does not seem to have any influence on the natural history of the disease.

Metástasis de nervio óptico secundaria a adenocarcinoma de pulmón / Optic nerve metastasis caused by lung adenocarcinoma

Introducción: Las metástasis del nervio óptico aisladas son extremadamente infrecuentes. Muchos casos se asocian con afectación de otras localizaciones como la coroides, órbita o el sistema nervioso central. Caso clínico: Mujer de 57 años de edad con el diagnóstico de adenocarcinoma de pulmón con pérdida brusca de la visión del ojo derecho. Ante los hallazgos encontrados y los resultados de la RMN se realiza el diagnóstico de metástasis del nervio óptico. Discusión: Las metástasis de nervio óptico aisladas son un cuadro infrecuente, pero que tendremos que sospechar en todo paciente con antecedentes oncológicos que presenten un deterioro de la agudeza visual (AU)

Introduction: Isolated optic nerve metastases are extremely uncommon. Many cases are associated with involvement from locations such as the choroid, orbit, or central nervous system. Optic nerve metastases often have their origin in primary tumours of the breast, lung, and stomach, in adults. Case report: The case is presented of a 57 year-old woman with a diagnosis of lung adenocarcinoma. Her first complaint was a sudden loss of visual acuity in her right eye. The diagnosis of optic nerve metastases was made based on her history, and the results of the MRI scan. Discussion: Isolated optic nerve metastases are an uncommon condition, but should be suspected in any patient with a history of oncology who has deteriorated visual acuity (AU)

Optic nerve metastasis caused by lung adenocarcinoma. / Metástasis de nervio óptico secundaria a adenocarcinoma de pulmón.

INTRODUCTION: Isolated optic nerve metastases are extremely uncommon. Many cases are associated with involvement from locations such as the choroid, orbit, or central nervous system. Optic nerve metastases often have their origin in primary tumours of the breast, lung, and stomach, in adults. CASE REPORT: The case is presented of a 57 year-old woman with a diagnosis of lung adenocarcinoma. Her first complaint was a sudden loss of visual acuity in her right eye. The diagnosis of optic nerve metastases was made based on her history, and the results of the MRI scan. DISCUSSION: Isolated optic nerve metastases are an uncommon condition, but should be suspected in any patient with a history of oncology who has deteriorated visual acuity.

Desprendimiento coroideo seroso bilateral tras trabeculoplastia selectiva láser / Bilateral choroidal effusion after selective laser trabeculoplasty

La trabeculoplastia selectiva láser (TSL) es un medio eficaz para tratar el glaucoma de ángulo abierto con una baja tasa de complicaciones. Reportamos el caso de una mujer de 73 años con un glaucoma primario de ángulo abierto no controlado que tras someterse a una trabeculoplastia selectiva láser en ambos ojos desarrolló un desprendimiento coroideo bilateral (AU)

Selective laser trabeculoplasty (SLT) is an effective treatment to treat open-angle glaucoma with a low risk of complications. The case is presented of a 73 year-old woman with uncontrolled primary open-angle glaucoma who underwent selective laser trabeculoplasty in both eyes and developed bilateral choroidal effusion (AU)

Bilateral choroidal effusion after selective laser trabeculoplasty. / Desprendimiento coroideo seroso bilateral tras trabeculoplastia selectiva láser.

Selective laser trabeculoplasty (SLT) is an effective treatment to treat open-angle glaucoma with a low risk of complications. The case is presented of a 73 year-old woman with uncontrolled primary open-angle glaucoma who underwent selective laser trabeculoplasty in both eyes and developed bilateral choroidal effusion.