ABSTRACT
BACKGROUND: Hidrocystoma, or sudoriferous cyst, is an eyelid tumor originating from apocrine or eccrine sweat glands. Its presence in the orbit is relatively rare. CASE PRESENTATION: A full-term female child with severe right eye extrusion was referred to our department two hours after birth. We performed cyst aspiration under ultrasonic guidance; 15 cc straw-colored fluid was obtained and proptosis resolved significantly. Orbital magnetic resonance imaging (MRI) showed a large unilocular retrobulbar mass with hypo-intensity in T1 and hyper-intensity in T2. The case underwent further daily ocular assessment until day 5; when proptosis began to worsen again. On day 6, under general anesthesia, we performed aspiration and then the cyst was completely removed with an intact wall through a trans-conjunctival incision. The diameter of the aspirated cyst was about 4 cm. In pathologic consultation, a cystic cavity lined by a layer of sweat duct like epithelium with apical snouts consistent with the diagnosis of apocrine hidrocystoma was reported. CONCLUSION: To date, in the literature, six other cases of orbital hidrocystoma have been reported in childhood with protean clinical pictures; none of which presented at birth. Herein, we introduce the first case report at birth and also provide a review on the literature. Our report strongly argues against the well reputed theory of traumatic origin for orbital hidrocystoma; it has been postulated that this tumor may be the result of sweat gland cells implantation through the orbit. We thereby suggest the possible presence of choristomatous ectopic sweat gland cells in the orbit during embryogenesis.
ABSTRACT
Diabetes mellitus, a multifactorial disorder, is related to the intestinal microbiota via numerous molecular mechanisms. The vast increase in the prevalence of diabetes and its associated complications requires a natural and safe solution. There is a growing evidence of gut microbiota effi ciency in improving insulin resistance, impaired insulin secretion, and metabolic complications in diabetic patients. Probiotics are defi ned as live microorganisms that, when ingested in adequate amounts, exert health benefi ts to the host. Probiotics can increase insulin sensitivity and reduce autoimmune responses by modulating intestinal microbiota and decreasing the infl ammatory reactions and oxidative stress. Recent evidences show that the intestinal microbiota infl uences the host through modulating intestinal permeability and mucosal immune response, manipulating eating behaviors by appetite-regulating hormones, including agouti related protein (AgRP), glucagon like peptide-1 (GLP-1) and neuropeptide Y, and controlling gut endocannabinoid (eCB) system which is now believed to be associated with infl ammation and diabetes. Moreover, intestinal microbiota control the host metabolism by affecting energy extraction from food and by biochemically converting molecules derived from the host or from gut microbes themselves. Experimental studies and clinical trials support the hypothesis that the modulation of the intestinal microbiota by probiotics, especially Lactobacillus and Bifidobacterium strains may be effective in prevention and management of diabetes. This review will highlight the current evidences in probiotic effectiveness and future prospects for exploring probiotic therapy in prevention and control of diabetes.
