Intravascular papillary endotelial hiperplasia, the unusual diagnosis of an orbital mass.

Intravascular papillary endotelial hyperplasia is a bening vascular lesion that rarely involves the periocular region, nevertheless, it should be considered in the differential diagnosis of a periorbital mass. It is histopatologically characterized by intravascular fibrous papillary fronds covered by endothelial cells. Histopathological differentiation from angiosarcoma can be challenging but is very important to avoid aggressive treatments. Complete surgical excision is frequently curative. Uncompleted excision can lead to recurrences. We describe the clinical and histological findings of intravascular papillary endotelial hyperplasia in the left lower lid of a 72-year-old woman who had a painless mass since 15 years ago, that caused hypertropia of her left eye. Histopathological examination revealed intralesional calcification, which is not an usual feature in this entity. The patient underwent complete surgical resection of the mass and there was no evidence of recurrence after 5 months of follow-up after surgery.

Hiperplasia endotelial papilar intravascular, el inusual diagnóstico de una masa orbitaria / Intravascular papillary endotelial hiperplasia, the unusual diagnosis of an orbital mass

La hiperplasia endotelial papilar intravascular es una lesión vascular benigna, infrecuente en la región periocular, pero que debe ser tenida en cuenta en el diagnóstico diferencial de una masa periorbitaria.Histopatológicamente se caracteriza por la proliferación intravascular de proyecciones papilares de tejido conectivo recubiertas por células endoteliales. La diferenciación anatomopatológica con el angiosarcoma puede ser difícil, pero es muy importante para evitar tratamientos agresivos. Generalmente, la escisión quirúrgica completa es curativa, mientras que una escisión incompleta puede causar recurrencias.Describimos un caso clínico de hiperplasia endotelial papilar intravascular en una mujer de 72 años que presentaba una masa palpebral inferior izquierda de 15 años de evolución que le provocaba hiperglobo del ojo izquierdo. El estudio histopatológico mostró la presencia de calcificación intralesional, característica infrecuente en esta patología.La masa fue extirpada completamente y tras 5 meses de seguimiento no mostró signos de recurrencia.

Intravascular papillary endotelial hyperplasia is a bening vascular lesion that rarely involves the periocular region, nevertheless, it should be considered in the differential diagnosis of a periorbital mass.It is histopatologically characterized by intravascular fibrous papillary fronds covered by endothelial cells. Histopathological differentiation from angiosarcoma can be challenging but is very important to avoid aggressive treatments. Complete surgical excision is frequently curative. Uncompleted excision can lead to recurrences.We describe the clinical and histological findings of intravascular papillary endotelial hyperplasia in the left lower lid of a 72-year-old woman who had a painless mass since 15 years ago, that caused hypertropia of her left eye. Histopathological examination revealed intralesional calcification, which is not an usual feature in this entity.The patient underwent complete surgical resection of the mass and there was no evidence of recurrence after 5 months of follow-up after surgery.

Intravascular papillary endotelial hiperplasia, the unusual diagnosis of an orbital mass. / Hiperplasia endotelial papilar intravascular, el inusual diagnóstico de una masa orbitaria.

Intravascular papillary endotelial hyperplasia is a bening vascular lesion that rarely involves the periocular region, nevertheless, it should be considered in the differential diagnosis of a periorbital mass. It is histopatologically characterized by intravascular fibrous papillary fronds covered by endothelial cells. Histopathological differentiation from angiosarcoma can be challenging but is very important to avoid aggressive treatments. Complete surgical excision is frequently curative. Uncompleted excision can lead to recurrences. We describe the clinical and histological findings of intravascular papillary endotelial hyperplasia in the left lower lid of a 72-year-old woman who had a painless mass since 15 years ago, that caused hypertropia of her left eye. Histopathological examination revealed intralesional calcification, which is not an usual feature in this entity. The patient underwent complete surgical resection of the mass and there was no evidence of recurrence after 5 months of follow-up after surgery.

Queratouveítis herpética bilateral en paciente inmunocompetente / Bilateral herpetic keratouveitis in an immunocompetent patient

CASO CLÍNICO: Se presenta el caso de un varón inmunocompetente que acude a nuestro servicio con escleritis adyacente a limbo y queratitis intersticial en ojo izquierdo. A los pocos días se observa nueva úlcera de aspecto dendritiforme en ojo derecho y empeoramiento bilateral progresivo hasta presentar uveítis granulomatosa en ambos ojos. En el estudio etiológico destacan títulos positivos de IgM para virus herpes simple en suero. DISCUSIÓN: Ante un cuadro de queratouveítis bilateral de tórpida evolución con tratamiento convencional, es necesario descartar el origen herpético debido a las diferentes presentaciones de este virus

CASE REPORT: We report the case of an immunocompetent male who presented with a limbal-adjacent scleritis and interstitial keratitis in the left eye. A few days later a new dendritiform ulcer in his right eye and bilateral progressive worsening with granulomatous uveitis in both eyes were observed. A thorough review of systems revealed positive serum IgM titles for herpes simplex virus. DISCUSSION: In the context of a bilateral keratouveitis refractory to conventional treatment it is mandatory to rule out the herpetic origin based on the different forms of clinical presentation of this virus

[Bilateral herpetic keratouveitis in an immunocompetent patient]. / Queratouveítis herpética bilateral en paciente inmunocompetente.

CASE REPORT: We report the case of an immunocompetent male who presented with a limbal-adjacent scleritis and interstitial keratitis in the left eye. A few days later a new dendritiform ulcer in his right eye and bilateral progressive worsening with granulomatous uveitis in both eyes were observed. A thorough review of systems revealed positive serum IgM titles for herpes simplex virus. DISCUSSION: In the context of a bilateral keratouveitis refractory to conventional treatment it is mandatory to rule out the herpetic origin based on the different forms of clinical presentation of this virus.

Eficacia analgésica de la morfina aplicada tópicamente sobre piel intacta. A propósito de tres casos / No disponible

Diversos estudios sugieren la eficacia analgésica de la morfina en gelintrasite® aplicada tópicamente sobre úlceras dolorosas. Presentamos tres casos de dolor localizado y con piel intacta en pacientes con enfermedad avanzada. En los tres casos el uso de gel de morfina 0,1% logró un excelente control del dolor

Several studies suggest that morphine in Intrasite® gel has an analgesic effect cohen applied to painful ulcers. We present three cases of local pain and intact skin in patients with advanced disease. By using 0.1% topical morphine a good control of pain was obtained