1/66. Immunohistochemical examination of an orbital alveolar soft part sarcoma.BACKGROUND: A 32 year-old male patient had a 6-week history of left-sided proptosis. Computer tomography revealed a 16x15x15 mm smooth and well-defined mass between the optic nerve and the medial and superior rectus muscles in the left orbit. methods: The tumour was excised via a cranio-medial orbitotomy approach. RESULTS: Histopathological examination, immunohistochemistry and electron microscopy findings were consistent with an alveolar soft part sarcoma. Immunohistochemical staining showed positive immunoreactivity for neuronespecific enolase, vimentin, p53 (30%), p21 (10%) and cyclin d1 (20%), and negative immunoreactivity for CD45, cytokeratins, S-100 protein, glial fibrillary acidic protein, synaptophysin, chromogranin, calcitonin, serotonin, thyreoglobulin, desmin, myosin, actin, HMB-45, pRB, p16 and BCL-2. The growth fraction of the tumour cells was 3%. At examination 4 years after surgical excision, there was no evidence of local recurrence or for metastases. CONCLUSION: Alveolar soft part sarcoma of the orbit is a rare malignant tumour best controlled by surgery. The unpredictable behaviour of these neoplasms, however, indicates the need for long-term follow-up.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
2/66. Stereolithographic modelling as an aid to orbital brachytherapy.PURPOSE: This paper describes the technique of stereolithographic biomodelling and its application to a patient who was treated using orbital brachytherapy. methods AND MATERIALS: The process uses a moving laser beam, directed by a computer, to draw cross-sections of the model onto the surface of photo-curable liquid plastic. Using a stereolithographic apparatus (SLA), solid or surface data is sliced by software into very thin cross-sections. A helium cadmium (HeCd) laser then generates a small intense spot of ultraviolet (UV) light that is moved across the top of a vat of liquid photo monomer by a computerised optical scanning system. The laser polymerises the liquid into a solid where it touches, precisely printing each cross-section. A vertical elevator lowers the newly formed layer, and a recoating and levelling system establishes the next layer's thickness. Successive cross-sections (0.25 mm thick), each one adhering to the one below, are built one on top of the other, to form the part from the bottom up. The biomodel allowed the implant to be planned in detail prior to the surgery. The accurate placement of brachytherapy catheters was assured, and the dosimetry could be determined and optimised prior to the definitive procedure. CONCLUSIONS: Stereolithography is a useful technique in the area of orbital brachytherapy. It allows the implant to to be carried out with greater accuracy and confidence. For the patient, it minimises the risk to the eye and provides them with a greater understanding of the procedure.- - - - - - - - - - ranking = 0.001666254508128keywords = process (Clic here for more details about this article) |
3/66. Fine structure of a radiation-induced osteogenic sarcoma.An osteogenic sarcoma arose in the right orbit of a 7-year-old boy some 5 years after the right orbit had been treated by four courses of radiotherapy (total dose approximately 13,000 rads) for a multicentric retinoblastoma. death occurred 6 months after the orbital tumor was first detected. Study of the orbital tumor by electron microscopy revealed a cell population of varied morphology in which two main types were identified. In one group, the cells were large with radiolucent cytoplasm, which contained long branching segments of rough endoplasmic reticulum. In the second group, the cells were smaller with irregular nuclei and an electron-dense cytoplasm, which contained short segments of dilated rough endoplasmic reticulum and numerous mitochondria. The first group of cells closely resembled osteoblasts, while the second group had some features of osteoclasts or their percursors. The branching processes of the tumor cells were separated by an amorphous ground substance, which contained collagen-like fibrils and hydroxyapatite crystals. Crystal deposition was in some instances in close relation to extracellular membrane-bound vesicles.- - - - - - - - - - ranking = 0.001666254508128keywords = process (Clic here for more details about this article) |
4/66. Solid facial edema preceding a diagnosis of retro-orbital B-cell lymphoma.Persistent solid facial edema is a rare condition of unknown cause. Although acute facial edema has been associated with numerous disease processes such as infections, neoplasms, immune disorders, inflammation, neuropathic processes, drugs, mechanical obstructions, and trauma, solid facial edema has most often been associated with acne vulgaris. We report the first case, to our knowledge, of solid facial edema preceding a diagnosis of a subcutaneous scalp and orbital/periorbital B-cell lymphoma.- - - - - - - - - - ranking = 0.0033325090162561keywords = process (Clic here for more details about this article) |
5/66. Reconstruction of the orbital floor after its removal for malignancy.Reconstruction of the orbital floor for malignant disease can be difficult. The tissue used should replace the floor itself and the orbital rim to ensure appropriate positioning of the globe and to avoid ectropion. The authors present a simple technique using temporalis muscle with attached coronoid process of the mandible that covers both these areas, and which is suitable for most defects in this area.- - - - - - - - - - ranking = 0.001666254508128keywords = process (Clic here for more details about this article) |
6/66. Unilateral exophthalmos investigated by infrared thermography.A group of 40 cases of unilateral exophthalmos have been investigated using infrared thermography. Two groups of cases can be distinguished according to the intensity of thermal anomalies: (a) no hyperthermy, allowing exclusion of an acute inflammation and rather suggesting an endocrinal process that nevertheless includes the possibility of a deep and/or weakly thermogenous tumor and (b) marked orbital hyperthermy, excluding any endocrinal origin and generally reflecting a malignant tumor.- - - - - - - - - - ranking = 0.001666254508128keywords = process (Clic here for more details about this article) |
7/66. Orbital rhabdomyosarcoma metastatic to the contralateral orbit: a case report.OBJECTIVE: To report a rare presentation of metastatic orbital rhabdomyosarcoma and the corresponding findings on magnetic resonance imaging (MRI). DESIGN: Interventional case report. RESULTS: A 29-year-old white man was diagnosed with rhabdomyosarcoma of the left sinus and orbit for which he was treated with chemotherapy and radiation. Eighteen months after diagnosis, he returned with subacute right eye pain and dysmotility of his extraocular muscles. MRI revealed solitary enlargement of the right medial rectus muscle, and thyroidopathy was suspected. Over the next 2 months, symptoms progressed, and proptosis developed. MRI showed infiltration of seven extraocular muscles. A biopsy of right orbital tissues and the right medial rectus muscle was performed. Special tissue typing confirmed metastatic alveolar rhabdomyosarcoma. The patient underwent palliative radiation therapy and chemotherapy, but he ultimately died of disseminated disease. CONCLUSIONS: rhabdomyosarcoma can rarely metastasize to the extraocular muscles. Earlier recognition of orbital metastasis through radiographic and biopsy findings, along with prompt and aggressive treatment, may prevent fulminant spread of rhabdomyosarcoma.- - - - - - - - - - ranking = 0.2keywords = alveolar (Clic here for more details about this article) |
8/66. The use of autologous autoclaved bone in orbital reconstruction after exenteration for invasive cutaneous carcinoma.PURPOSE: To describe a technique for reconstructing the orbital bony architecture after invasion by tumour. methods: Orbital bone invaded by tumour was osteotomized (post-exenteration), autoclaved to remove tumour cells, and then refixated in order to re-establish the normal orbital anatomy. RESULTS: Despite some shrinkage of the bone fragment in the autoclaving process, after refixation the contour and topography of the bony orbit was essentially normal. CONCLUSION: Autoclaved bone can be used to reconstruct the exenterated orbit; it is a fast and technically simple strategy for maintaining orbital anatomy when faced with bony invasion by tumour.- - - - - - - - - - ranking = 0.001666254508128keywords = process (Clic here for more details about this article) |
9/66. Solitary fibrous tumor of the orbit.Painless unilateral proptosis is a frequent manifestation of numerous orbital neoplastic and non-neoplastic processes. Various mesenchymal tumors of both fibrohistiocytic and vascular origin are well-described causes. Solitary fibrous tumors (SFTs) are rare spindle-cell neoplasms usually found associated with serosal surfaces, especially the pleura, but they have recently been described in a number of extrapleural sites including the orbit. The authors describe the case of an 18-year-old man who presented with a 6-month history of painless proptosis in the right eye. A visible nontender mass in the right supermedial orbit producing ptosis of the upper lid was present. magnetic resonance imaging (MRI) showed a well-circumscribed soft tissue mass located above the right globe with no obvious invasion of adjacent orbital structures. Uneventful surgical excision through a right frontal-orbitotomy approach was performed. Histological evaluation showed a solid, highly vascular tumor mass composed of spindle cells arranged in short ill-defined fascicles. Intense immunohistochemistry staining for CD34 and B-cell lymphoma 2 (BCL-2) differentiated the lesion from the more common hemangiopericytoma. Though considered benign, local recurrence and extraorbital extension of orbital SFTs have been described. Malignant behavior, including distant metastases, has been documented in as many as 20% of pleural cases with mortality rates as high as 50%. The natural history of this tumor in the orbit is unclear. The authors report the 35th case of orbital solitary fibrous tumor and discuss the differential diagnosis, histopathology, radiological features, and clinical course.- - - - - - - - - - ranking = 0.001666254508128keywords = process (Clic here for more details about this article) |
10/66. Gaze-evoked amaurosis: a report of five cases.OBJECTIVE: To highlight the various causes of gaze-evoked amaurosis. DESIGN: Retrospective noncomparative interventional case series. PARTICIPANTS: Five patients treated at our facility over the past 6 years. methods: Clinical presentation, radiologic studies, surgical management, and postsurgical results are presented. MAIN OUTCOME MEASURES: visual acuity, clinical findings of gaze-evoked amaurosis. RESULTS: Only two patients had classic intraorbital etiologies, one with an intraconal cavernous hemangioma and one with an intraconal foreign body. Three patients had extraorbital processes, two with orbital fractures and one with a sinus tumor. Only two of our patients initially were aware of the gaze-evoked amaurosis at presentation. Appropriate surgery was curative in all cases. CONCLUSIONS: Gaze-evoked amaurosis is a rare condition, classically implicating intraconal orbital pathology. In one of the largest case series published to date, we found extraorbital etiologies are also capable of producing gaze-evoked vision loss. Gaze-evoked amaurosis should be suspected and tested for in any orbital condition.- - - - - - - - - - ranking = 0.001666254508128keywords = process (Clic here for more details about this article) |
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