Pleomorphic Adenoma of the Eyelid with Apocrine Gland Origin; an Atypical Location.

PURPOSE: To describe the clinical presentation and treatment of a patient with a cutaneous pleomorphic adenoma of the eyelid. CASE REPORT: A 73-year-old male patient presented with a nodular mass on the lateral third of his right upper eyelid, which had slowly enlarged over 10 years. Radiologic features were of an extra-conical mass, with no invasion of adjacent structures. An excisional biopsy of the lesion was performed. The histopathological examination revealed a biphasic tumor, composed of tubules with a double layer of epithelial cells arranged in a chondromyxoid stroma. The inner epithelial cells were positive for pancytokeratins AE1/AE3 and carcinoembryonic antigen. The outer epithelial cells and stromal component expressed vimentin and S100 protein. These pathologic findings were consistent with a palpebral pleomorphic adenoma, with an apocrine gland origin. CONCLUSION: Pleomorphic adenomas of the skin are rare tumors, and even less frequent as tumors of the ocular adnexa. These lesions should be considered in the differential diagnosis of palpebral nodular masses, and complete excision should be attempted due to the possibility of malignant transformation.

Evaluation of Choroidal Thickness and Volume during the Third Trimester of Pregnancy using Enhanced Depth Imaging Optical Coherence Tomography: A Pilot Study.

BACKGROUND: During pregnancy the maternal choroid is exposed to the multiple haemodynamic and hormonal alterations inherent to this physiological condition. These changes may influence choroidal anatomy. In this study a quantitative assessment of overall choroidal structure is performed, by constructing a 3-dimensional topographic map of this vascular bed. PURPOSE: To compare the thickness and volume of the maternal choroidal in the third trimester of pregnancy with that of an age-matched control group of women. MATERIALS AND METHODS: Twenty-four eyes of 12 pregnant women in the last trimester and 12 age-matched healthy controls (24 eyes) were included. Optical coherence tomography in enhanced depth imaging mode was used to construct maps of the choroid of the macular area. Choroidal thickness and volume were automatically calculated for the 9 subfields defined by the Early Treatment Diabetic Retinopathy Study (ETDRS). A comparative analysis between the two groups was performed using the two-way ANOVA test. RESULTS: The average thickness of the choroid for the entire ETDRS area of the pregnant group was 295.15 ±42.40µm and 271.56 ±37.65µm in the control group (p=0.051). The average choroidal volume was 8.05 ±1.12mm(3) and 7.46 ±1.03mm(3), respectively (p=0.067). Although the choroid of the pregnant group had larger thickness and volume in all subfields compared to the control group, this difference was statistically significant only in three regions - the central subfield, minimum foveal thickness and inferior inner macula (p<0.05). CONCLUSION: Our study suggests that in the third trimester of pregnancy the choroid may be subjected to physiological changes in structure. Whether these changes are a result of hormonal and/or haemodynamic adaptations of pregnancy remains to be studied.

Chronic myeloid leukemia diagnosed in a patient with uncontrolled proliferative diabetic retinopathy.

PURPOSE: To report a case of uncontrolled proliferative diabetic retinopathy as an initial manifestation of chronic myeloid leukemia. METHODS: Case report. PATIENTS: A 55-year-old man with moderate nonproliferative diabetic retinopathy who rapidly developed proliferative retinopathy and bilateral neovascular glaucoma despite good glycemic control. CONCLUSION: Other pathologies should be excluded in diabetic patients with a rapid and severe progression in their retinopathy despite adequate metabolic control. These patients should be treated promptly and aggressively until systemic disease is stable.