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1/126. Lacrimal sac diverticula associated with a patent lacrimal system.

    PURPOSE: To describe the clinical features of lacrimal sac diverticula. methods: Orbital masses were evaluated in 3 patients. One patient had a large tumor extending from the medial orbit associated with upward globe displacement, one had a mass inferior to the medial canthus, and one had an inflamed mass in the right lower lid. Two of the patients had no history of chronic epiphora, sinus disease, or nasal trauma. In all patients, irrigation demonstrated lacrimal drainage system patency. RESULTS: Surgical exploration confirmed the diagnosis of lacrimal sac diverticulum in all patients. Two diverticula were associated with a dacryolith. Each patient was successfully managed with excision of the diverticulum and dacryocystorhinostomy. CONCLUSIONS: Lacrimal sac diverticula should be considered in the diagnosis of medial orbital tumors, and computed tomography is useful in the diagnosis of lacrimal sac diverticula.
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ranking = 1
keywords = orbital
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2/126. Non-Hodgkin's lymphoma of the lacrimal sac and concomitant pansinusitis.

    Paranasal sinus disease has an established propensity to breach anatomical barriers and present with orbital clinical features. Lacrimal sac lymphomas on the other hand are rare, usually present in males in the sixth decade and 50 per cent of cases have systemic lymphoma/leukaemia. Atypical presentations of lymphomas at this and other sites are reported in patients with acquired immunodeficiency syndrome (AIDS). The clinical features, investigations and treatment of a young human immunodeficiency virus (hiv) sero-negative woman with a non-Hodgkin's lymphoma localized to the lacrimal sac and presenting with a concomitant ipsilateral pansinusitis is described. The importance of submitting surgical material for pathological investigation is stressed.
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ranking = 1
keywords = orbital
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3/126. ethmoid sinus osteoma presenting as epiphora and orbital cellulitis: case report and literature review.

    Paranasal sinus osteoma is a slow-growing, benign, encapsulated bony tumor that may be commonly asymptomatic, being detected incidentally in 1% of plain sinus radiographs or in 3% of sinus computerized tomographic scans. In a patient presenting with orbital cellulitis and epiphora, computed tomography disclosed a large osteoma of the ethmoid sinus. Excision of the osteoma allowed recovery of vision, return of extraocular muscle function, and resolution of choroidal folds. Proptosis, diplopia, and visual loss are other frequent presenting signs of paranasal osteomas. epidemiology, diagnosis, treatment, and pathologic findings in paranasal sinus osteoma are reviewed.
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ranking = 5
keywords = orbital
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4/126. Unusual presentations of pleomorphic adenoma and adenoid cystic carcinoma of the lacrimal gland.

    PURPOSE: To report two atypical cases of pleomorphic adenoma and adenoid cystic tumours of the lacrimal gland. methods: Two case reports are presented. The first is of a 65-year-old female with a long history of right hypoglobus with sudden recent worsening. Computed tomography (CT) showed a round, well-defined lesion in the fossa for the lacrimal gland with an anterior hypodense extension suggestive of possible malignancy in a pleomorphic adenoma. The tumour in the second case, a 35-year-old male, was diagnosed after presentation following a relatively minor periorbital injury. The smooth rounded mass on CT scan was suggestive of a benign lacrimal gland tumour. RESULTS: The lesion in case 1 was excised with a diagnosis of haemorrhage within a pleomorphic adenoma. The lesion in case 2 was excised with a diagnosis of adenoid cystic carcinoma of the lacrimal gland with pseudocapsule. CONCLUSIONS: Haemorrhagic cyst developing beneath the pseudocapsule of a pleomorphic adenoma should be considered in the differential diagnosis of secondary development of malignancy in a pleomorphic adenoma. Adenoid cystic tumours of the lacrimal gland can present with a pseudocapsule.
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ranking = 1
keywords = orbital
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5/126. Benign pleomorphic adenoma arising from the palpebral lobe of the lacrimal gland associated with elevated intraocular pressure.

    A 46-year-old man complained of a painless mass in the left upper eyelid. At age 51 years, the patient complained of dull pain in the left eye and diplopia. His left intraocular pressure had increased to 33 mm Hg. No proptosis was noted. The nontender mass in the eyelid was palpable. Computed tomography showed a mass anterior to the orbital rim compressing the globe. The lesion was removed en bloc by a transconjunctival approach. Histopathologic examination of the excised mass showed myxomatous stroma and highly cellular epithelial areas. Postoperatively, the left intraocular pressure normalized. To our knowledge, benign pleomorphic adenomas arising from the palpebral lobe of the lacrimal gland associated with elevated intraocular pressure, as demonstrated in our patient, may be rare.
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ranking = 1
keywords = orbital
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6/126. Ductal cysts of the accessory lacrimal glands: CT findings.

    Benign ductal cysts of the accessory lacrimal glands are uncommon lesions of the orbit, arising from the glands of Wolfring and Krause. We report two patients with histopathologically proved cysts in whom CT scans revealed well-circumscribed extraconal cystic lesions adjacent to the globe, involving both eyelids. Radiologists should be aware of these rare lesions so as to include them in the differential diagnosis of orbital cysts.
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ranking = 1
keywords = orbital
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7/126. Kimura disease of the orbit and ocular adnexa.

    Kimura disease (KD) is a distinct clinicopathologic entity that has been the subject of considerable confusion and debate. Although common in Asia, KD rarely occurs in non-Asian patients. Kimura disease shares both clinical and histopathologic features with angiolymphoid hyperplasia with eosinophilia (ALHE). Because of this overlap and the rarity of KD in europe and the united states, KD and ALHE have been used synonymously in the Western medical literature, as they were thought to represent variations of the same disease. Some pathologic reports have called for distinguishing KD and ALHE as two separate entities, based on their histologic features. Kimura disease occurs most commonly in the head and neck region and has been described in the orbit, eyelids, and lacrimal gland more frequently than ALHE. Because both diseases can cause proptosis, lid swelling, ocular dysmotility, or a palpable mass, they should be considered in the differential diagnosis of orbital lesions occurring in adults. We report two cases of KD involving the orbit and ocular adnexa, and review additional cases reported in the literature. The ophthalmic literature does not clearly reflect the current understanding that KD and ALHE are best considered two separate clinicopathologic entities.
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ranking = 1
keywords = orbital
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8/126. Presumed periorbital lupus vulgaris with ocular extension.

    OBJECTIVE: To report an unusual case of lupus vulgaris that spread to the left anterior ocular surface. DESIGN: Case report. PARTICIPANT: An 18-year-old woman presented with an 8-month history of an infiltrative skin lesion affecting the left lower eyelid and cheek area, left globe, right lacrimal sac area, together with a cystic lesion in the foot area. TESTING/INTERVENTION: The authors describe the clinical findings, radiologic study, and histopathologic study of the conjunctiva, skin, liver, and ankle lesion. The patient was treated with antituberculous medications for 3 months. MAIN OUTCOME MEASURES: Healing of the skin, conjunctival, and bone lesions. RESULTS: The lesion of the face healed, leaving scar tissue. The left eye showed symblepharon with loss of its anterior surface features. The right eye showed no symblepharon, the bones of the foot healed with no deformity, and the liver function test results normalized after 3 months of antituberculous medications. CONCLUSION: lupus vulgaris can be associated with multiple system involvement. Its clinical presentation and behavior depend on the patient's immunity and duration of the disease. early diagnosis and appropriate management may cure the disease with no life-threatening sequelae.
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ranking = 4
keywords = orbital
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9/126. Invasion of the lacrimal system by basal cell carcinoma.

    BACKGROUND: The rate of recurrence of basal cell carcinoma (BCC) in the periorbital region is higher than that in other areas because of the spread of the tumor along barrier structures. OBJECTIVE: A better understanding of the biological behavior of BCC in this area, in particular as it relates to the lacrimal system, should improve the outcome of surgery. methods: A study was made of two cases of BCC that developed in the periorbital region and invaded the lacrimal system. RESULTS: The tumors were found to have invaded the lacrimal system along the mucosal epithelium. magnetic resonance imaging (MRI) did not suggest any abnormalities in this area. In one patient, the tumor had infiltrated the nasal cavity without destruction of the periorbital bone and nasal cartilage. A preoperative fiberscopic examination clearly demonstrated the involvement of the nasal cavity in this case. CONCLUSION: The lacrimal system is often invaded by BCC that originates from the periorbital region. physicians and surgeons need to be well aware of the possibility of such aggressive infiltration by BCC.
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ranking = 4
keywords = orbital
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10/126. Mucoepidermoid carcinoma of an accessory lacrimal gland with orbital invasion.

    PURPOSE: To report a case of mucoepidermoid carcinoma of an accessory lacrimal gland with orbital invasion. methods: The clinical history and pathologic findings of a patient with a left upper eyelid lesion were reviewed. RESULTS: The patient was evaluated and found to have an epithelial tumor arising in an accessory lacrimal gland. Special stains showed mucin production by individual tumor cells. The tumor was classified as mucoepidermoid carcinoma. CONCLUSIONS: Mucoepidermoid carcinoma may arise in accessory lacrimal glands and invade the orbit.
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ranking = 5
keywords = orbital
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