1/28. magnetic resonance imaging of acquired Brown syndrome in a patient with psoriasis.PURPOSE: To report the occurrence of acquired Brown syndrome and associated magnetic resonance imaging findings in a patient with psoriasis. methods: A 42-year-old woman with a history of psoriasis developed pain, double vision, and limited elevation of her left eye in adduction. An orbital magnetic resonance image with gadolinium enhancement was obtained. RESULTS: Orbital magnetic resonance image disclosed abnormal enhancement of the left trochlea/tendon complex. The patient's symptoms resolved with corticosteroid therapy. CONCLUSIONS: Acquired Brown syndrome may be associated with psoriasis. The inflammation of the trochlea/tendon complex that can cause acquired Brown syndrome can be demonstrated on magnetic resonance image.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
2/28. Congenital, paradoxical lower eyelid retraction on upgaze.PURPOSE: Active lower eyelid retraction on upgaze is a rarely described finding. The purpose of this study is to describe the clinical and operative findings in two patients with this unique eyelid movement disorder. methods: The authors identified active, unilateral lower eyelid retraction on upgaze in two patients who had no other ocular or systemic abnormalities. RESULTS: Surgical extirpation of the lower eyelid retractor complex was carried out in both cases. During one of the procedures, performed under local anesthesia, the lower eyelid retractors were observed to retract actively on upgaze. Postoperatively, lower eyelid retraction on upgaze was not present in either case. CONCLUSIONS: The authors are aware of only one other case report describing active, paradoxical lower eyelid retraction on upgaze. The mechanism of eyelid retraction in this previous report and in the two patients described herein is not known. The authors postulate that these unique cases may represent a previously unrecognized form of congenital, aberrant innervation of the oculomotor nerve.- - - - - - - - - - ranking = 0.5keywords = complex (Clic here for more details about this article) |
3/28. Bilateral abortive cryptophthalmos associated with oculocutaneous albinism.PURPOSE: To document a case of bilateral abortive cryptophthalmos associated with oculocutaneous albinism. methods: We describe a 13-year-old female patient with blond skin and hair who had anomalous face and eyes first noted at birth. RESULTS: The patient had fair hair and complexion, bilateral anomalous wedge of scalp hair, upper eyebrow and eyelid deformities, cup-shaped ears, broad based nose with depressed bridge and midline groove, iris transillumination and diffuse hypopigmentation and foveal hypoplasia in fundus examination. CONCLUSION: Based on the clinical and laboratory findings, the reported case represents tyrosinase-positive oculocutaneous albinism together with bilateral abortive cryptophthalmos. The oculocutaneous albinism can either be an entirely new criterion to the whole syndrome of cryptophthalmos, or, more probably, the condition can be due to a double affliction which is primarily related with consanguinity of the parents. The importance of ante-natal diagnosis and genetic counseling are emphasized in such cases where the two recessive genes for two different conditions coexist.- - - - - - - - - - ranking = 0.5keywords = complex (Clic here for more details about this article) |
4/28. Nonconvulsive status epilepticus in eyelid myoclonia with absences--evidence of provocation unrelated to photosensitivity.A 10-year old girl with eyelid myoclonia with absences (EMA) in whom nonconvulsive status epilepticus developed shortly after awakening is described. A video-polygraphic recording during the status showed the characteristic eye-closure provocation of eyelid myoclonia with upward deviation of the eyeballs and brief absences. Ictal EEG showed generalized polyspikes concomitant with eyelid myoclonia, while absences were accompanied by 3.5 Hz polyspike-wave complexes on EEG. This condition occurred even in total darkness as well as even after seizures precipitated by bright sunlight had been eliminated by medication. The present case suggests that the eye closure mechanism could be a more potent precipitating factor than photosensitivity in the pathophysiology of EMA.- - - - - - - - - - ranking = 0.5keywords = complex (Clic here for more details about this article) |
5/28. Phakomatous choristoma: a case report and review of the literature.Phakomatous choristoma is a rare congenital lesion of the eyelid that can be clinically and/or histologically mistaken for a cyst, cutaneous adnexal neoplasm, or an ocular adnexal oncocytoma. Only 13 such cases have been previously described, mostly in the English language ophthalmic literature. Zimmerman reported the first case in 1971 and proposed the lesion to be of lenticular anlage origin, a theory that has been widely accepted. We report an additional case occurring in an 8-week-old male infant with a firm nodule of the right lower eyelid that was present since birth. A 15 x 12 x 2 mm circumscribed solid nodule with a homogenously white cut surface was surgically excised. Histologically, this lesion was comprised of cuboidal cells forming cystically dilated and irregularly branched ducts and cords within a densely fibrotic stroma. Also present were eosinophilic basement membranelike material, psammoma body-like calcifications and intraluminal degenerated ghost cells. The immunohistochemical profile of the epithelial cells included strong immunoreactivity for vimentin, focal weak staining for S-100, and negative staining for cytokeratin, epithelial membrane antigen, synaptophysin, and chromogranin. The irregularity of the ducts and cords of epithelial cells within the densely fibrotic stroma resembled an infiltrative neoplasm of cutaneous adnexal or lacrimal duct origin. However, the site of involvement, the peculiar basement membrane material, ghost cells, and immunohistochemical profile were features that helped to distinguish phakomatous choristoma from an infiltrative carcinoma. The correct identification of this lesion is essential to avoid an aggressive surgical excision, thus sparing the eyelid and lacrimal system. The purpose of this article is to bring attention to this rare entity, because it has not been described in either the dermatology or dermatopathology literature and furthermore, is not mentioned in any of the major dermatopathology texts.- - - - - - - - - - ranking = 2.0299945179732keywords = neoplasm (Clic here for more details about this article) |
6/28. Solitary fibrous tumour of the orbit. Report of a new case.PURPOSE: Solitary fibrous tumour (SFT) of the orbit is a very rare lesion that may be misdiagnosed as fibrous histiocytoma, haemangiopericytoma, or other orbital tumour. We studied a case of SFT of the orbit in a 35-year-old woman. methods: The patient, with a 1-year history, reported a 'pressure' sensation behind her right eye, but no pain, vision changes, or other associated symptoms. Ocular examination was normal. magnetic resonance imaging (MRI) showed a well-circumscribed medial mass in the right orbit. The tumour was excised. RESULTS: The tumour was a cellular spindle-cell neoplasm with a storiform pattern. The tumour cells were spindle-shaped with bland nuclei and rare mitoses. Immunostaining was positive for vimentin and CD34, but negative for cytokeratin (AE1-AE3), EMA, desmin, smooth muscle actin, S-100, CD31, CD45 and bcl-2. CONCLUSION: SFT can infrequently involve the orbit. The tumour must be removed entirely to avoid recurrences. Careful and continued follow-up is important because orbital recurrence may occur several years after the excision of the primary tumour.- - - - - - - - - - ranking = 1.0149972589866keywords = neoplasm (Clic here for more details about this article) |
7/28. A new technique for levator lengthening to treat upper eyelid retraction: the orbital septal flap.Correction of upper eyelid retraction can be achieved by numerous techniques. We have developed a new flap, the orbital septal flap, to interpose between the recessed levator complex and the tarsus to correct the retracted upper eyelid of a young girl. The orbital septum is a facial structure; it is readily available and easy to dissect. The flap acts like a vascularited spacer without the problem of resorption; normal anatomical continuity of the levator mechanism can be functionally restored. We believe the orbital septal flap is a promising technique for correcting upper eyelid retraction; however, more case studies are needed.- - - - - - - - - - ranking = 0.5keywords = complex (Clic here for more details about this article) |
8/28. Use of hard palate grafts for treatment of postsurgical lower eyelid retraction: a technical overview.Lower eyelid retraction occasionally occurs following the repair of fractures involving the orbital rims, orbital floor, or complex zygomatic maxillary complex fractures. The surgical repair of these scarred eyelids has been historically difficult. The authors have utilized the principle of releasing the scar tissue and attempting to reposition the eyelid in its normal anatomic position by employing a hard palate mucosal graft spacer to correct the eyelid malposition. In this article, the authors discuss the excellent success they have experienced utilizing hard palate autologous grafts as spacers performing revision of scarred contracted lower eyelid retractors and tightening of the lateral canthal tendon complex. Adherence to the principles delineated in the article can yield excellent functional and cosmetic results.- - - - - - - - - - ranking = 1.5keywords = complex (Clic here for more details about this article) |
9/28. False diagnosis caused by Warthin tumor of the parotid gland combined with actinomycosis.A case is reported in which a unilateral parotid gland cystadenolymphoma was combined with actinomycosis. A 48-year-old woman presented with a mass in the left parotid region and paresis of the lower left palpebra. The computed tomography, echography, and parotid radiographic findings did not exclude a neoplasm of the left parotid gland. The ramus of the mandible was involved in the process. Intraoperative freezing histology, total parotidectomy, and partial mandibulectomy were performed, with sacrifice of the facial nerve followed by nerve reconstruction. The final histological evaluation was Warthin tumor with actinomycosis. Four years after treatment, the patient is free of disease. No similar cases seem to have been reported thus far.- - - - - - - - - - ranking = 1.0149972589866keywords = neoplasm (Clic here for more details about this article) |
10/28. Phakomatous choristoma of the eyelid.BACKGROUND: We report a case of a phakomatous choristoma of the lower eyelid. methods: A subcutaneous tumor was excised from the eyelid. RESULTS: A 12-month-old girl was referred because of a tumor in her right lower eyelid, which had been present since birth. The subcutaneous tumor had remained unchanged and was considered a dermoid cyst. No other abnormalities were present. The tumor was excised. Histologically, the tumor consisted of abnormal lens tissue. The immunohistochemical profile included strong immunoreactivity for vimentin and S-100. CONCLUSION: Phakomatous choristoma is an extraordinary rare tumor that probably develops from an abnormal separation or migration of cells from the lens placode into the mesodermal structures of the lid. Only 18 cases have been described so far, less than 5 in the European literature. This benign tumor may be confused with cutaneous adnexal neoplasms.- - - - - - - - - - ranking = 1.0149972589866keywords = neoplasm (Clic here for more details about this article) |
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