Topical imiquimod 5% as an alternative therapy in periocular basal cell carcinoma in two patients with surgical contraindication. / Imiquimod 5% tópico como terapia alternativa en carcinoma basocelular periocular en 2 pacientes con contraindicación quirúrgica.

CLINICAL CASES: The cases are presented of two patients with periocular basal cell carcinoma of the eyelid who received topical imiquimod 5%, with a good response. Both had a functional state that contraindicated surgical treatment. CONCLUSION: Imiquimod cream 5% was shown to be an effective alternative to surgical treatment of periocular basal cell carcinoma, especially in those cases where surgery is not possible.

Metástasis coroidea de carcinoma renal / Choroidal metastasis from renal cell carcinoma

Caso clínico: Hombre de 52 años que acudió a urgencias por disminución progresiva de su visión en el ojo derecho. Como antecedentes había tenido nefrectomía derecha por carcinoma renal 7 años antes y neumonectomía derecha por metástasis 3 meses antes. En la funduscopia se observaba una masa coroidea en ojo derecho, compatible con metástasis. Se realizó enucleación. Durante un año permaneció sin progresión pero en los últimos seis meses ya ha aparecido. Discusión: Las metástasis coroideas de carcinoma renal son infrecuentes y pueden ocurrir varios años después de la curación del primario. Su sintomatología es variable y su aspecto poco característico por lo que puede dificultar su diagnóstico diferencial(AU)

Case report: A fifty-two year-old man who came to our emergency room because of gradual loss of vision in his right eye. He had suffered right nefrectomy for renal cell carcinoma seven years previously and pneumectomy for metastasis in his right lung three months ago. In the fundus examination a choroidal mass was found in his right eye, suggesting metastasis. Treatment was enucleation of the affected eye. During the first year there was no progression, but in the last six months it has re-appeared. Discussion: Choroidal metastasis of renal cell carcinoma is rare and can appear years after treating the primary tumour. Its symptoms are variable, and its shape is not very characteristic so it can be difficult to make a differential diagnosis(AU)

[Orbit xanthogranulomatosis. Erdheim-Chester disease]. / Xantogranulomatosis orbitaria. Enfermedad de Erdheim-Chester.

CASE REPORT: A patient was studied because of upper lid bilateral edema and xanthelasmae-like lesions after three years of evolution. During the ophthalmologic examination orange-yellowish lesions and two symmetrical tumours were observed on the temporal part of both upper lids. Corticoid-therapy was undertaken which reduced the size of the tumours, however the size increased again after the discontinuation of treatment. A biopsy was performed and lid xanthogranulomatosis was diagnosed. Other systemic examinations were normal. DISCUSSION: Erdheim-Chester disease is a xanthogranulomatosis that can affect ocular and periorbital structures. Combination of xanthelasmae-like lesions and bilateral orbital masses should make us consider this process and try to locate any associated systemic conditions.

Xantogranulomatosis orbitaria: Enfermedad de Erdheim-Chester / Orbit xanthogranulomatosis. Erdheim-Chester disease

Caso clínico: Paciente con edema bilateral de párpados superiores y lesiones similares a xantelasmas de tres años de evolución. La exploración oftalmológica mostraba dos tumoraciones temporales simétricas en ambos párpados superiores con lesiones naranjo-amarillentas. Se pautaron corticoides que hicieron disminuir el tamaño de las tumoraciones, con recidiva de los mismos al suspender dicha medicación. La biopsia reveló una xantogranulomatosis palpebral. El resto de las exploraciones sistémicas fueron normales. Discusión: La enfermedad de Erdheim-Chester es una xantogranulomatosis que puede afectar a las estructuras oculares y periorbitarias. La combinación de lesiones similares a xantelasmas y masas orbitarias bilaterales deben hacernos pensar en este proceso y buscar la posible afectación sistémica(AU)

Case report: A patient was studied because of upper lid bilateral edema and xanthelasmae-like lesions after three years of evolution. During the ophthalmologic examination orange-yellowish lesions and two symmetrical tumours were observed on the temporal part of both upper lids. Corticoid-therapy was undertaken which reduced the size of the tumours, however the size increased again after the discontinuation of treatment. A biopsy was performed and lid xanthogranulomatosis was diagnosed. Other systemic examinations were normal. Discussion: Erdheim-Chester disease is a xanthogranulomatosis that can affect ocular and periorbital structures. Combination of xanthelasmae-like lesions and bilateral orbital masses should make us consider this process and try to locate any associated systemic conditions(AU)

[Choroidal metastasis from renal cell carcinoma]. / Metástasis coroidea de carcinoma renal.

CASE REPORT: A fifty-two year-old man who came to our emergency room because of gradual loss of vision in his right eye. He had suffered right nefrectomy for renal cell carcinoma seven years previously and pneumectomy for metastasis in his right lung three months ago. In the fundus examination a choroidal mass was found in his right eye, suggesting metastasis. Treatment was enucleation of the affected eye. During the first year there was no progression, but in the last six months it has re-appeared. DISCUSSION: Choroidal metastasis of renal cell carcinoma is rare and can appear years after treating the primary tumour. Its symptoms are variable, and its shape is not very characteristic so it can be difficult to make a differential diagnosis.