Severe absence of intra-orbital fat in a patient with orbital venous malformation:A case report

BACKGROUND The orbital venous malformation is quite common in orbital diseases.Clinically,it is usually characterized by proptosis.However,among patients with distensible venous malformations,if the lesions continuously progress,they may induce enlargement of the orbital bone or orbital lipoatrophy,which in turn leads to enophthalmos.CASE SUMMARY Here,we report a patient who presented with enophthalmos and had a severe absence of intra-orbital fat secondary to orbital venous malformation.The patient was a 66-year-old female with a 20-year history of enophthalmos.Hertel exophthalmometry readings in a relaxed upright position were 4 mm OD and 13 mm OS with a 97 mm base.It was determined that she had positional“proptosis”.Physical examination also revealed a bulging mass on her hard palate.Computed tomographic scan and magnetic resonance imaging showed an expansion of the right orbit with local bony defects and multiple soft-tissue masses.CONCLUSION Long-term lack of awareness about the presence of orbital venous malformations,persistent venous congestion could lead to compression of the orbital fat,which in turn induces atrophy or the absence of intra-orbital fat.

Prognostic factors for lacrimal gland adenoid cystic carcinoma:a retrospective study in Chinese patients

AIM:To explore the prognostic factors for lacrimal gland adenoid cystic carcinoma(LGACC)in Chinese patients.METHODS:Clinical and histopathological data were reviewed in patients with pathologically confirmed LGACC.Local recurrence,metastasis,and disease-specific death were the main outcome measures.Univariate and multivariate analyses were performed by the Kaplan-Meier method and a Cox proportional hazard model.RESULTS:This retrospective cohort study included 45 patients with pathologically confirmed LGACC between January 2008 and June 2022.Tumor(T)classification(P=0.005),nodal metastasis(N)classification(P=0.018)and positive margin(P=0.008)were independent risk factors of recurrence;T(P=0.013)and N(P=0.003)classification and the basaloid tumor type(P=0.032)were independent risk factors for metastasis;T classification(P<0.001)was an independent factor of death of disease.In the further analysis,the durations from first surgery to radiotherapy is correlated with metastatic risk in LGACC patients with basaloid component(P=0.022).CONCLUSION:Histological subtype should be emphasized when evaluating prognosis and guiding treatment.Timely radiotherapy may reduce the risk of metastasis in patients with basaloid component.