Objectives: To present a large series of patients with orbital invasion by per iocular basal cell carcinoma (BCC). Design: Retrospective, noncomparative, inter ventional case series. Patients: All cases diagnosed with...Objectives: To present a large series of patients with orbital invasion by per iocular basal cell carcinoma (BCC). Design: Retrospective, noncomparative, inter ventional case series. Patients: All cases diagnosed with orbital invasion by pe riocular BCC between January 1985 and July 2004 in 3 Orbital Units in Australia. Methods: The clinical records of all patients were reviewed. Main Outcome Measu res: Patients’demographics, clinical presentation, histologic subtypes, treatme ntmodalities, recurrence rate, and tumor-related death. Results: There were 64 patients (49 males) with a mean age of 70±13 years. Most tumors (84.4%) were r ecurrent or previously incompletely excised, and the medial canthus was most fre quently involved (56.2%). Signs suggestive of orbital involvement included a ma ss with bone fixation (35.7%), limitation of ocular motility (30.4%), and glob e displacement (17.6%). There were no signs suggestive of orbital invasion in 3 5.7%. Most patients (51.6%)-had infiltrative histologic findings, and perineu ral invasion was present in 19.3%. Treatment modalities were mainly exenteratio n alone or combined with radiotherapy. During a mean follow-up period of 3.6 ye ars, 3 cases of recurrence (4.7%)were diagnosed. Only 1 patient (1.6%) died fr om tumor-related causes. Conclusions: Orbital invasion by periocular BCC is an uncommon event that may be associated with significant ocular morbidity and, rar ely, death. Because orbital invasion may often be clinically silent, clinicians need to be alert to the possibility in high-risk tumors and consider appropriat e imaging. Surgical treatment with exenteration or excision, with or without rad iotherapy, results in a low recurrence and mortality rate.展开更多
Purpose: To present a patient with rosacea lymphoedema of one upper eyelid res ulting in unilateral complete ptosis. Methods: A 51-year-old white man present ed with a 12-month history of progressive painless swelling...Purpose: To present a patient with rosacea lymphoedema of one upper eyelid res ulting in unilateral complete ptosis. Methods: A 51-year-old white man present ed with a 12-month history of progressive painless swelling of the left upper e yelid. An incisional biopsy of the upper eyelid was performed. Results: The biop sy showed dermal oedema with lymphangiectasia and telangiectasia, accompanied by a mild to moderate mixed chronic inflammatory infiltrate of lymphocytes, histio cytes, plasma cells and rare eosinophils. Stains for fungi and mycobacteria were negative. The lack of lichenoid reaction, dermal mucin or lip swelling indicate d a lymphoedematous manifestation of rosacea. The patient was treated with minoc ycline and prednisolone with no effect. Conclusion: Rosacea lymphoedema involvin g the eyelid, as in our case, is a rare complication and can present diagnostic and therapeutic challenges to the ophthalmologist.展开更多
文摘Objectives: To present a large series of patients with orbital invasion by per iocular basal cell carcinoma (BCC). Design: Retrospective, noncomparative, inter ventional case series. Patients: All cases diagnosed with orbital invasion by pe riocular BCC between January 1985 and July 2004 in 3 Orbital Units in Australia. Methods: The clinical records of all patients were reviewed. Main Outcome Measu res: Patients’demographics, clinical presentation, histologic subtypes, treatme ntmodalities, recurrence rate, and tumor-related death. Results: There were 64 patients (49 males) with a mean age of 70±13 years. Most tumors (84.4%) were r ecurrent or previously incompletely excised, and the medial canthus was most fre quently involved (56.2%). Signs suggestive of orbital involvement included a ma ss with bone fixation (35.7%), limitation of ocular motility (30.4%), and glob e displacement (17.6%). There were no signs suggestive of orbital invasion in 3 5.7%. Most patients (51.6%)-had infiltrative histologic findings, and perineu ral invasion was present in 19.3%. Treatment modalities were mainly exenteratio n alone or combined with radiotherapy. During a mean follow-up period of 3.6 ye ars, 3 cases of recurrence (4.7%)were diagnosed. Only 1 patient (1.6%) died fr om tumor-related causes. Conclusions: Orbital invasion by periocular BCC is an uncommon event that may be associated with significant ocular morbidity and, rar ely, death. Because orbital invasion may often be clinically silent, clinicians need to be alert to the possibility in high-risk tumors and consider appropriat e imaging. Surgical treatment with exenteration or excision, with or without rad iotherapy, results in a low recurrence and mortality rate.
文摘Purpose: To present a patient with rosacea lymphoedema of one upper eyelid res ulting in unilateral complete ptosis. Methods: A 51-year-old white man present ed with a 12-month history of progressive painless swelling of the left upper e yelid. An incisional biopsy of the upper eyelid was performed. Results: The biop sy showed dermal oedema with lymphangiectasia and telangiectasia, accompanied by a mild to moderate mixed chronic inflammatory infiltrate of lymphocytes, histio cytes, plasma cells and rare eosinophils. Stains for fungi and mycobacteria were negative. The lack of lichenoid reaction, dermal mucin or lip swelling indicate d a lymphoedematous manifestation of rosacea. The patient was treated with minoc ycline and prednisolone with no effect. Conclusion: Rosacea lymphoedema involvin g the eyelid, as in our case, is a rare complication and can present diagnostic and therapeutic challenges to the ophthalmologist.
