1/145. color Doppler image of central retinal artery of eyes with an intraconal mass.PURPOSE: Retinal ischemia secondary to hypoperfusion of the central retinal artery is recognized as one factor that may contribute to the development of loss of vision in eyes with intraorbital tumors. We study intraorbital tumors which produce motility disturbances and visual problems by color Doppler imaging to evaluate this factor. methods: We examined the central retinal artery velocities of 3 patients with disc edema caused by intraconal masses (2 cavernous hemangiomas and 1 presumed optic nerve glioma) via color Doppler imaging. RESULTS: The time-velocity waveform demonstrated abnormally high vascular resistance in the central retinal artery of all affected eyes in the primary position compared with the normal waveform seen in the other eyes. We compared the pulsatility index of eyes with an intraconal mass and contralateral, control eyes using Student's t test for paired samples and significant differences were noted between both groups (p< 0.01). CONCLUSIONS: Intraconal tumors could produce increased pressure in the optic nerve sheath and the optic nerve tissue which could be associated with impaired retinal and optic nerve blood flow and the subsequent amaurosis encountered with intraorbital tumors.- - - - - - - - - - ranking = 1keywords = hemangioma (Clic here for more details about this article) |
2/145. Removal of orbital apex hemangioma using new transorbital craniotomy through suprabrow approach.PURPOSE: To describe a technique combining the expertise of the oculoplastic orbital surgeon and the neurosurgeon which allows access to the posterior orbit, anterior fossa, cavernous sinus and suprasellar region with minimal brain manipulation. methods: A transorbital craniotomy through a suprabrow incision is performed removing part of the frontal bone and orbital roof as a single piece. This allows wide access with only minimal, if any, brain retraction. The superior, lateral and medial orbit is clearly visualized, as well as the apex of the orbit. The bone flap is replaced at the end of the case with tantalum plates. RESULTS: A cavernous hemangioma at the orbital apex was removed without complications. The exposure was superb and allowed identification and preservation of orbital structures. CONCLUSIONS: Transorbital craniotomy allows for wide access to the posterior orbit and parasellar region and anterior fossa of the brain with minimal brain manipulation. The use of a suprabrow incision results in an excellent cosmetic result. There is minimal postoperative morbidity, which decreases hospitalization time.- - - - - - - - - - ranking = 5keywords = hemangioma (Clic here for more details about this article) |
3/145. Orbital fibrous histiocytoma: case report and literature review.BACKGROUND: Fibrous histiocytomas are a diverse group of soft tissue tumors classified histiologically as benign, locally aggressive, and malignant. These tumors are found throughout the body, but seem to have an affinity for the periorbital area. They account for one percent of all ocular masses and are the most common primary mesenchymal tumor of the orbit. Associated ocular signs and symptoms include decreased visual acuity, proptosis, diplopia, pain, restricted extraocular muscle movement, swelling of the eyelids, and conjunctiva, as well as disk edema. CASE REPORT: A case of a benign orbital fibrous histiocytoma is presented. The patient reported intermittent pain and occasional diplopia; severe edema of the right upper eyelid; and proptosis and inferior vertical displacement of the right globe were observed. Computed tomography revealed a well-defined mass that was subsequently surgically removed and histopathological results from the Armed-Forces pathology Institute confirmed the diagnosis. CONCLUSIONS: Orbital fibrous histiocytomas are rare periocular tumors that can manifest multiple ocular signs and symptoms. Careful histologic examination is necessary for diagnosis, since these tumors have a wide range of morphology. Differential diagnoses include orbital masses with similar radiologic or histologic findings.- - - - - - - - - - ranking = 38.650040879764keywords = histiocytoma (Clic here for more details about this article) |
4/145. Frontal intraosseous cryptic hemangioma presenting with supraorbital neuralgia.Primary intraosseous cranial hemangiomas are rare benign tumors comprising 0.2% of all osseous neoplasms. Symptomatic cranial cryptic hemangiomas are extremely rare. We report the case of a 43-year-old man with a cryptic hemangioma of the superior orbital rim. Radiological investigations revealed it to be an intraosseous cryptic mass which was totally excised and the supraorbital nerve was decompressed, relieving the patient of his symptoms. Histopathology showed features of an intraosseous hemangioma.- - - - - - - - - - ranking = 8keywords = hemangioma (Clic here for more details about this article) |
5/145. Surgical excision of selected amblyogenic periorbital capillary hemangiomas.To report the successful surgical excision of well-circumscribed capillary hemangiomas of the eyelid and orbit inducing occlusion amblyopia in 2 cases with immediate improvement of the patient's symptoms. A 2-month-old girl was diagnosed with a massive, amblyogenic orbital tumor which was removed intact via an inferior transconjunctival orbitotomy after magnetic resonance imaging (MRI) revealed a well-defined mass filling the entire inferior orbit. Histopathologic examination confirmed the diagnosis of orbital capillary hemangioma. A 1-month-old girl developed occlusion amblyopia due to an enlarging subcutaneous tumor of the left upper eyelid. The discrete mass was excised via an eyelid crease approach and confirmed to be an eyelid capillary hemangioma. There were no short-term or long-term complications in either case. In both cases, immediate resolution of occlusion amblyopia and cosmetic disfiguration was achieved. The final visual acuities were 20/20 at 5 years in the first patient and 20/30 at 4 years follow-up in the second patient. Orbital and eyelid capillary hemangiomas can induce profound permanent amblyopia. If the tumor is well-circumscribed, confirmed with orbital imaging, then surgical excision, with immediate resolution of amblyogenic factors, can be considered as a treatment option.- - - - - - - - - - ranking = 8keywords = hemangioma (Clic here for more details about this article) |
6/145. Sotradecol (sodium tetradecyl sulfate) injection of orbital lymphangioma.PURPOSE: To describe the results of intralesional injection of the sclerosing agent sodium tetradecyl sulfate in patients with lymphangioma. methods: Three patients (one child and two adults) were treated. RESULTS: Two patients had improvement in the size of the lymphangioma, although the result was short-lived in one instance. Minimal change was noted in the third patient. Two patients had transient edema and ecchymosis, and one patient had a mild allergic reaction to the injected solution. CONCLUSIONS: sodium tetradecyl sulfate may be a useful therapeutic option for some patients with eyelid or orbital lymphangioma, particularly if a previous operation has not been performed.- - - - - - - - - - ranking = 0.011805198604778keywords = sclerosing (Clic here for more details about this article) |
7/145. The clinical spectrum of schwannomas presenting with visual dysfunction: a clinicopathologic study of three cases.Schwannomas (neurilemomas) are benign tumors that arise from schwann cells in the peripheral nervous system. The most commonly involved nerves that cause neuro-ophthalmic manifestations are cranial nerves V and VIII. In this series of three women, schwannomas presented as intraconal masses that mimicked a cavernous hemangioma, a superior orbital mass transgressing the superior orbital fissure, and an expansive frontal lobe mass with clinical symptoms and signs of increased intracranial pressure. Although all three complained of visual blurring, none of our patients presented with Vth or VIIIth cranial nerve dysfunction. Histopathologic studies demonstrated well-circumscribed, encapsulated spindle-cell lesions with classic Antoni A and B patterns. Histopathologic examination is essential to confirm the diagnosis of a schwannoma that may be otherwise clinically confusing. Direct optic nerve compression, globe indentation with induced hyperopia, or increased intracranial pressure with optic nerve compromise may be responsible for visual symptoms. A multidisciplinary approach is often required because of the size and location of schwannomas.- - - - - - - - - - ranking = 1keywords = hemangioma (Clic here for more details about this article) |
8/145. Epithelioid hemangioma of the orbit.OBJECTIVE: To describe the histopathologic features of two cases of epithelioid hemangioma occurring in the orbit and to distinguish this condition from Kimura's disease and from other vascular lesions of proliferated endothelium. DESIGN: Two interventional case reports. INTERVENTION: Treatment consisted of orbitotomy with excision of the tumor. MAIN OUTCOME MEASURES: Histopathologic examination including light microscopy, immunohistochemistry, and electron microscopy and clinical follow-up. RESULTS: In one case, there was no local recurrence after 2 years of follow-up. In the other case, local recurrence required re-excision 2 years after surgery with no apparent recurrence 16 years later. Histopathologic examination of both tumors disclosed an epithelioid hemangioma. A characteristic finding was the presence of peculiar plump vacuolated endothelial cells lining the vascular lumina. CONCLUSIONS: Epithelioid hemangioma is an uncommon benign vascular tumor that can occur in the orbit, and surgical excision is usually required. It is the same condition as angiolymphoid hyperplasia with eosinophilia. There are distinct clinical and histopathologic characteristics to distinguish epithelioid hemangioma from Kimura's disease and from other vascular tumors.- - - - - - - - - - ranking = 8keywords = hemangioma (Clic here for more details about this article) |
9/145. 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 = 5.5214344113948keywords = histiocytoma (Clic here for more details about this article) |
10/145. radiosurgery for hemangiomas of the cavernous sinus and orbit: technical case report.OBJECTIVE AND IMPORTANCE: Hemangiomas of neurosurgical interest are histologically benign vascular tumors that most often occur in the orbit or cavernous sinus. Hemangiomas can be diagnosed by their characteristic radiographic and angiographic appearance and their tendency to bleed excessively during attempted removal. Intracranial or intraorbital hemangiomas require treatment when they become symptomatic. CLINICAL PRESENTATION: We report four hemangioma patients who presented with ocular symptoms or signs, such as orbital pain, ophthalmoplegia, proptosis, or impaired visual acuity. Before our evaluation, two patients had each had incomplete resections aborted because of excessive blood loss, one patient had undergone a nondiagnostic transsphenoidal biopsy, and one patient had had an unsuccessful embolization. INTERVENTION: All four patients were treated with gamma knife radiosurgery. Tumors received a minimal tumor dose that ranged from 14 to 19 Gy. Follow-up evaluations were performed 6 to 24 months after radiosurgery and revealed a reduction in tumor volume in three patients and no tumor progression in the fourth. All patients had symptomatic improvement, but one had persistent diplopia. CONCLUSION: In this early experience, stereotactic radiosurgery proved to be an effective management strategy that avoided the potentially serious complications associated with surgery or embolization of cavernous sinus hemangiomas.- - - - - - - - - - ranking = 7keywords = hemangioma (Clic here for more details about this article) |
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