Purpose: To report the clinical findings and management of multiple, recurrent cavernous hemangiomas of the orbit in a patient with concurrent liver involvement. Design: Interventional case report. Methods: An analysi...Purpose: To report the clinical findings and management of multiple, recurrent cavernous hemangiomas of the orbit in a patient with concurrent liver involvement. Design: Interventional case report. Methods: An analysis of clinical findings, radiology and treatment was conducted with a literature review. Results: A 35-year-old woman with blurry vision and proptosis was found to have multiple cavernous hemangiomas of the orbit. The tumors were excised completely without complication, and the patient subsequently regained her vision. Fifteen years later, the patient had recurrent, multiple cavernous hemangiomas in the same orbit. Further investigations for vague back pain revealed a presumed cavernous hemangioma in the liver and a presumed schwannoma arising from the neural foramen of the spine at the level of T2 through T4. Conclusion: Multiple cavernous hemangiomas may recur after complete excision and may exist with concurrent systemic tumors.展开更多
Conjunctival squamous cell carcinoma is generally a low-grade malignancy. A 42-year-old man presented with histologic evidence of extra-tumoral perineural invasion associated with an incompletely excised limbal conjun...Conjunctival squamous cell carcinoma is generally a low-grade malignancy. A 42-year-old man presented with histologic evidence of extra-tumoral perineural invasion associated with an incompletely excised limbal conjunctival squamous cell carcinoma. Despite further surgery, close observation, plaque radiotherapy, and eyelid-sparing orbital exenteration followed by external beam radiotherapy, the patient developed intracranial perineural invasion with involvement of the trigeminal and facial nerves, ultimately resulting in death. Repeated magnetic resonance imaging with contrast failed to detect perineural invasion until late in the course of disease. Awareness of the possibility of perineural invasion in patients with conjunctival squamous cell carcinoma and of its aggressive nature may be life-saving. Nevertheless, even with initial aggressive tumor control, some patients will show an aggressive tumor growth with recurrences.展开更多
Purpose To determine if harvesting free tarsal grafts from the upper eyelids i s associated with significant morbidity. Design Prospective case series. Methods Consecutive patients managed with free tarsal grafts by t...Purpose To determine if harvesting free tarsal grafts from the upper eyelids i s associated with significant morbidity. Design Prospective case series. Methods Consecutive patients managed with free tarsal grafts by three of the authors (D .S., D.G., R.G.) over a 4 year period. Results Ninety one eyelids in 75 patien ts were operated on using the free tarsal graft for various eyelid pathologies. Mean follow up period was 14.83 ±8.45 months (range, 4 to 42 months). Contour peaking in donor upper eyelid appeared in two eyelids (2.2%), lash ptosis in fo ur eyelids (4.4%) of three patients, and donor site infection in one eyelid (1. 1%). Four patients (5.3%) complained of a transient ocular discomfort. There w ere no cases of postoperative changes on the eyelid height, entropion, or kerato pathy in the donor site eye. Most of the donor site complications were mild or t ransient and required no further surgery. In three patients who underwent subseq uent surgery to treat preexisting ptosis or retraction of the donor eyelid, the results were less predictable and further procedures were required. Conclusion F ree tarsal grafts harvested from the upper eyelids, with preservation of at leas t 4 mm of the tarsal plate inferiorly, do not lead to significant donor site mor bidity. However, subsequent procedures to alter the position of the donor eyelid may be less predictable.展开更多
文摘Purpose: To report the clinical findings and management of multiple, recurrent cavernous hemangiomas of the orbit in a patient with concurrent liver involvement. Design: Interventional case report. Methods: An analysis of clinical findings, radiology and treatment was conducted with a literature review. Results: A 35-year-old woman with blurry vision and proptosis was found to have multiple cavernous hemangiomas of the orbit. The tumors were excised completely without complication, and the patient subsequently regained her vision. Fifteen years later, the patient had recurrent, multiple cavernous hemangiomas in the same orbit. Further investigations for vague back pain revealed a presumed cavernous hemangioma in the liver and a presumed schwannoma arising from the neural foramen of the spine at the level of T2 through T4. Conclusion: Multiple cavernous hemangiomas may recur after complete excision and may exist with concurrent systemic tumors.
文摘Conjunctival squamous cell carcinoma is generally a low-grade malignancy. A 42-year-old man presented with histologic evidence of extra-tumoral perineural invasion associated with an incompletely excised limbal conjunctival squamous cell carcinoma. Despite further surgery, close observation, plaque radiotherapy, and eyelid-sparing orbital exenteration followed by external beam radiotherapy, the patient developed intracranial perineural invasion with involvement of the trigeminal and facial nerves, ultimately resulting in death. Repeated magnetic resonance imaging with contrast failed to detect perineural invasion until late in the course of disease. Awareness of the possibility of perineural invasion in patients with conjunctival squamous cell carcinoma and of its aggressive nature may be life-saving. Nevertheless, even with initial aggressive tumor control, some patients will show an aggressive tumor growth with recurrences.
文摘Purpose To determine if harvesting free tarsal grafts from the upper eyelids i s associated with significant morbidity. Design Prospective case series. Methods Consecutive patients managed with free tarsal grafts by three of the authors (D .S., D.G., R.G.) over a 4 year period. Results Ninety one eyelids in 75 patien ts were operated on using the free tarsal graft for various eyelid pathologies. Mean follow up period was 14.83 ±8.45 months (range, 4 to 42 months). Contour peaking in donor upper eyelid appeared in two eyelids (2.2%), lash ptosis in fo ur eyelids (4.4%) of three patients, and donor site infection in one eyelid (1. 1%). Four patients (5.3%) complained of a transient ocular discomfort. There w ere no cases of postoperative changes on the eyelid height, entropion, or kerato pathy in the donor site eye. Most of the donor site complications were mild or t ransient and required no further surgery. In three patients who underwent subseq uent surgery to treat preexisting ptosis or retraction of the donor eyelid, the results were less predictable and further procedures were required. Conclusion F ree tarsal grafts harvested from the upper eyelids, with preservation of at leas t 4 mm of the tarsal plate inferiorly, do not lead to significant donor site mor bidity. However, subsequent procedures to alter the position of the donor eyelid may be less predictable.
