ABSTRACT
PURPOSE: To report the occurrence of delayed orbital hemorrhage after cataract surgery with retrobulbar anesthesia in a patient with previously unknown acquired factor VIII antibodies. METHODS: Interventional case report. A 79-year-old woman underwent uneventful cataract surgery with retrobulbar anesthesia and subsequently incurred a severe orbital hemorrhage 12 hours postoperatively. RESULTS: Despite aggressive surgical and medical intervention, the patient lost all vision in the involved eye. CONCLUSION: Delayed postoperative retrobulbar hemorrhage may cause total loss of vision in patients with acquired factor VIII antibodies.
Subject(s)
Autoantibodies/blood , Factor VIII/immunology , Hemophilia A/diagnosis , Phacoemulsification/adverse effects , Retrobulbar Hemorrhage/etiology , Aged , Anesthesia, Local , Blindness/etiology , Female , Hemophilia A/therapy , Humans , Partial Thromboplastin TimeABSTRACT
Malignant nonchromaffin paraganglioma (chemodectoma) is an unusual tumor arising from chemoreceptor cells derived from the neural crest. Although these tumors generally occur in the head and neck, where the term "carotid body tumor" applies, more than 20 cases of retroperitoneal origin have been described. This case report presents the clinical, radiographic, and pathologic features of a chemodectoma arising in the retroperitoneal area that produced severe hypertension by unilateral real vascular compression. The patient underwent exploratory laparotomy, and a left nephrectomy was done. Follow-up examination 1 year after surgery disclosed no clinical evidence of disease, and he had normal blood pressures without medication.
Subject(s)
Hypertension, Renal/etiology , Hypertension, Renovascular/etiology , Paraganglioma, Extra-Adrenal/complications , Renal Artery Obstruction/etiology , Retroperitoneal Neoplasms/complications , Adult , Humans , Male , Paraganglioma, Extra-Adrenal/diagnostic imaging , Paraganglioma, Extra-Adrenal/pathology , Renal Artery Obstruction/complications , Renal Artery Obstruction/diagnostic imaging , Retroperitoneal Neoplasms/diagnostic imaging , Retroperitoneal Neoplasms/pathology , Tomography, X-Ray ComputedABSTRACT
Association of monoclonal gammopathies of undetermined significance with primary hyperparathyroidism has been reported by several investigators. We reviewed the records of our cases of surgically proven parathyroid adenoma with serum protein electrophoresis within 6 months preceding parathyroidectomy. Among 911 patients who had hyperparathyroidism and were more than 50 years old, immunoelectrophoresis revealed a monoclonal gammopathy of undetermined significance in nine (1.0%). This incidence is similar to those in two studies of a normal population (1.25% and 1.6%). In our nine patients, the monoclonal proteins ranged from 1.0 to 1.9 g/dl. The monoclonal protein was unchanged during follow-up (median 62 months) in eight and increased in one (who probably has evolving multiple myeloma). Nine of the 911 patients with hyperparathyroidism had a malignancy, and this also is similar to previously reported experience.
