11/377. Periocular deep cutaneous basal cell carcinoma.PURPOSE: The distinction between benign and malignant cutaneous periocular lesions can be difficult, as the clinical history and appearance are often quite similar. When present, typical cutaneous changes are often helpful in distinguishing between benign and malignant neoplasms. However, when tumors lack characteristic epidermal change, histopathologic examination may be necessary to confirm the diagnosis. The authors present their experience in the evaluation and management of two patients with periocular basal cell carcinoma who were initially diagnosed as having benign cysts. methods: The case records for two patients with periocular basal cell carcinoma were reviewed. Preoperative and postoperative photographs were available for comparison in one case. For each patient, the medical history, clinical presentation, histology, and surgical outcome were reviewed. RESULTS: In each case, the periocular mass was initially diagnosed as a benign process. Histopathologic examination following excisional biopsy established the diagnosis of basal cell carcinoma in both patients. Following biopsy, residual tumor was removed by the Mohs micrographic technique. There were no surgical complications and no tumor recurrences during follow-up of one year and eight years. CONCLUSIONS: Periocular basal cell carcinoma may mimic benign cystic lesions of the central face. Incorrect diagnosis may result in delayed or inappropriate therapy, or failure to submit seemingly benign lesions for histopathologic examination. Definitive treatment requires complete excision with histologic margin control.- - - - - - - - - - ranking = 1keywords = cell (Clic here for more details about this article) |
12/377. Solitary fibrous tumor of the lacrimal sac.PURPOSE: Solitary fibrous tumor is a rare spindle cell tumor arising in the pleura. We report two cases of this tumor occurring in the lacrimal sac. methods: A 23-year-old man and a 34-year-old woman presented with a medial canthal mass. They underwent surgical excision of their tumors. RESULTS: solitary fibrous tumors were diagnosed by light microscopy, immunohistochemical study, and electron microscopy. Immunohistochemical staining showed that tumor cells were reactive with vimentin and CD34 and demonstrated no smooth muscle or neural differentiation (nonreactive with desmin and S-100 protein). CONCLUSIONS: The findings indicate that solitary fibrous tumor can occur in the lacrimal sac and may recur locally if it is removed incompletely. To our knowledge, these are the first reported cases of solitary fibrous tumors occurring in the lacrimal sac.- - - - - - - - - - ranking = 0.28301702806806keywords = cell, spindle (Clic here for more details about this article) |
13/377. Invasion of the lacrimal system by basal cell carcinoma.BACKGROUND: The rate of recurrence of basal cell carcinoma (BCC) in the periorbital region is higher than that in other areas because of the spread of the tumor along barrier structures. OBJECTIVE: A better understanding of the biological behavior of BCC in this area, in particular as it relates to the lacrimal system, should improve the outcome of surgery. methods: A study was made of two cases of BCC that developed in the periorbital region and invaded the lacrimal system. RESULTS: The tumors were found to have invaded the lacrimal system along the mucosal epithelium. magnetic resonance imaging (MRI) did not suggest any abnormalities in this area. In one patient, the tumor had infiltrated the nasal cavity without destruction of the periorbital bone and nasal cartilage. A preoperative fiberscopic examination clearly demonstrated the involvement of the nasal cavity in this case. CONCLUSION: The lacrimal system is often invaded by BCC that originates from the periorbital region. physicians and surgeons need to be well aware of the possibility of such aggressive infiltration by BCC.- - - - - - - - - - ranking = 0.625keywords = cell (Clic here for more details about this article) |
14/377. Basal cell adenocarcinoma of the lacrimal gland.PURPOSE: Basal cell adenocarcinoma is a recently recognized entity among malignant tumors of the salivary glands. This entity has not received enough attention among ophthalmologists and ophthalmic pathologists. We recommend that basal cell adenocarcinoma be included in the differential diagnosis of lacrimal gland tumors. DESIGN: Case report. methods: In 1988 a lacrimal gland tumor was incompletely removed from the left orbit of a 36-year-old woman and diagnosed as "solid basaloid adenoid cystic carcinoma". Soon after, an exenteration of the orbit was performed. In 1998, upon review of the initial histopathology, the diagnosis of solid adenoid cystic carcinoma was changed to basal cell adenocarcinoma. RESULTS AND MAIN OUTCOME MEASURE: The pathologic findings included nests of basaloid cells with minimal atypia and incomplete palisading around the periphery. The cells were of two types. The first type were large, pale cells with round or oval nuclei, scanty cytoplasm, and ill-defined borders. The other type were smaller cells with hyperchromatic nuclei situated mainly near the periphery of the nests. There was no necrosis or perineural invasion. Mitotic figures were present. cysts within the nests showed alcian blue negative contents. immunohistochemistry showed a positive reaction to cytokeratin and a negative reaction with smooth muscle actin (SMA). CONCLUSIONS: The alcian blue negative stain, the negative reaction to SMA, and the fact that the patient is still alive 10 years after exenteration favored the diagnosis of basal cell adenocarcinoma. It is essential to differentiate a basal cell adenocarcinoma of the lacrimal gland from the solid basaloid type of adenoid cystic carcinoma, because the former has a better prognosis. patients with basal cell adenocarcinomas of the lacrimal gland should be closely monitored for local recurrences because this tumor has the tendency to show perineural invasion.- - - - - - - - - - ranking = 1.75keywords = cell (Clic here for more details about this article) |
15/377. T-cell lymphoproliferative disorder of vitreous associated with mycosis fungoides.59-year-old man with a history of mycosis fungoides developed loss of visual acuity and visual field in the left eye. Epiretinal lesions were present in the right eye and multifocal choroidal lesions, optic disc edema, and vitritis were present in the left eye. A diagnostic vitrectomy was performed and cytologic examination of the vitreous confirmed the diagnosis of T-cell lymphoproliferative disorder. Systemic and intrathecal chemotherapy resulted in marked improvement in ocular signs and symptoms. At last follow-up, the patient was found to have improved visual acuity in the left eye; however, significant worsening of his systemic condition developed and he died shortly thereafter.- - - - - - - - - - ranking = 0.625keywords = cell (Clic here for more details about this article) |
16/377. Nonsmall cell lung adenocarcinoma metastatic to the vitreous without fundus lesions.A 76-year-old man presented with vitritis in the absence of visible fundus lesions. Vitreal cytologic analysis revealed adenocarcinoma; immunostaining was consistent with a pulmonary origin. This case highlights the need to exclude metastasis to the vitreous in a patient with an oncologic history, even in the absence of visible posterior segment lesions. It also illustrates the utility of immunostaining to better determine the tissue of origin when a metastatic lesion is encountered.- - - - - - - - - - ranking = 0.5keywords = cell (Clic here for more details about this article) |
17/377. adenoma of the pigmented ciliary epithelium: ultrastructural and immunohistochemical findings.We report the clinical and histological findings in a tumor of the pigmented ciliary epithelium. The tumor was detected because it had caused a unilateral cataract, and it was removed by local resection because a malignant melanoma could not be excluded. The diagnosis was established by light microscopy, and additional immunohistochemical and detailed ultrastructural studies were performed. The so-called foam cells which are considered typical of these adenomas appear to be mostly light microscopic artifacts and had no ultrastructural equivalent in the sections examined from our tumor. Our results also strongly support the hypothesis that no true glandular elements are formed and that, apart from the neoplastic tissue architecture, most of the pathological findings are related to melanosomes.- - - - - - - - - - ranking = 0.125keywords = cell (Clic here for more details about this article) |
18/377. Corneal myxoma associated with keratoconus and Down's syndrome.PURPOSE: Primary myxoma of the cornea is extremely rare. Until now, only four primary corneal myxomas were reported in the literature, whereas secondary involvement of the cornea by conjunctival and limbal tumors is much more common. methods: We report an additional case in a 26-year-old woman with keratoconus and Down's syndrome. Excision of the corneal mass was performed by penetrating keratoplasty. Histochemical, immunohistochemistry, and ultrastructural studies were used to obtain a definitive diagnosis. RESULTS: The tumor exhibited the characteristic histologic features of myxoma. The tumor cells showed immunoreactivity for vimentin but not for S-100 protein, epithelial membrane antigen, CAM 5.2, HHF-35, or muscle-specific actin. Ultrastructural features were fibroblast-like or stellate cells with cytoplasm containing abundant, rough reticulum and dilated cisternae. No recurrence was observed 36 months after penetrating keratoplasty. CONCLUSION: This is only the fifth report of such an occurrence. Although the coexistence of myxoma in Down's syndrome with keratoconus is described here for the first time, the differential diagnosis of apparently evident acute hydrops on clinical inspection should not rule out the possibility of a corneal myxoma. Histologic analysis should therefore be performed.- - - - - - - - - - ranking = 0.25keywords = cell (Clic here for more details about this article) |
19/377. Rotary atlanto-axial subluxation with torticollis following central-venous catheter insertion.Atlanto-axial subluxation with torticollis is an uncommon condition that occurs in children usually as a result of pharyngeal infection, minor trauma, or neck surgery. Passive motion of the head and neck during general anesthesia is probably another etiologic factor. torticollis is the most common presenting physical finding. pain may or may not be present, but is commonly present with passive neck motion. Neurologic sequelae are uncommon. Our case illustrates this condition as a complication of central venous catheter (CVC) insertion in a child under general anesthesia. The surgeon should suspect this pathology when a child presents with torticollis following CVC placement. Precautions should be taken in the operating room to avoid aggressive rotation and extension of the child's neck while under general anesthesia whether or not cervical inflammation is present. Special attention to head and neck positioning should be taken in patients with Down's syndrome since they are at increased risk for atlanto-axial subluxation. The prognosis is excellent when diagnosed early. A delay in diagnosis can result in the need for surgical intervention.- - - - - - - - - - ranking = 0.125keywords = cell (Clic here for more details about this article) |
20/377. Anterior uveal and episcleral metastases from carcinoma of the breast.breast carcinoma is the most common primary tumor producing intraocular metastasis. Metastases to the iris and ciliary body are relatively rare. The authors report a case of a 61-year-old lady, operated for carcinoma of the left breast 3 years back, who presented with symptoms and signs of acute narrow-angle glaucoma in the right eye. A diffuse whitish plaque-like mass in the upper nasal quadrant of the iris with an episcleral nodule on the limbus in the corresponding area and all the signs of acute narrow-angle glaucoma were present in the right eye. intraocular pressure was controlled medically. Fine-needle aspiration cytology from the episcleral nodule showed malignant cells. Histopathology of the excised nodule showed metastatic poorly differentiated carcinoma, and the cellular pattern was similar to the carcinoma of the breast. There was no other metastasis anywhere in the body. Fine-needle aspiration cytology from an external lesion of the eye is a less invasive and easier procedure than paracentesis to diagnose the metastatic nature of the lesions. The rare features in our case are the clinical presentation as acute glaucoma and the ocular structures being the first and only site of metastasis.- - - - - - - - - - ranking = 0.25keywords = cell (Clic here for more details about this article) |
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