1/15. Giant cell angiofibroma of the orbit and eyelid.PURPOSE: To report the clinicopathologic features of a newly recognized tumor, giant cell angiofibroma. DESIGN: Observational case series. MAIN OUTCOME MEASURES: Clinical and histopathologic features of giant cell angiofibroma. methods: light and electron microscopy and immunohistochemistry of five cases of giant cell angiofibroma. RESULTS: A total of five patients (4 women and 1 man) are described: two presented with a painless mass in the eyelid, two with a mass in the orbit, and one presented with a conjunctival lesion. All lesions were well demarcated with no capsule and were composed of blood vessels, a patternless spindle-shaped cell proliferation with a solid and pseudovascular appearance, and multinucleated giant cells. Both spindle-shaped and giant tumor cells were intensely positive for CD34 and vimentin. CONCLUSION: Giant cell angiofibroma resembles solitary fibrous tumor and giant cell fibroblastoma and should be considered in the differential diagnosis of spindle-cell tumors in the eyelid, orbit, and conjunctiva.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/15. ear helix flap for reconstruction of total loss of the upper eyelid.We present a patient with a recurrent carcinoma of the right upper eyelid who underwent resection of the subtotal upper eyelid resulting in a full-thickness defect. The eyelid was reconstructed with advanced conjunctival lining and an ascending helix chondrocutaneous flap from the right auricle. This flap was nourished with a reverse flow of the frontal branch of the superficial temporal vessels. A superficial temporal vein of the flap was anastomosed to the zygomaticofacial branch of the superficial temporal vein at the lateral canthal region to ensure adequate drainage. The flap survived without any congestion. An ascending helix flap is the best candidate for total loss of the upper eyelid.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/15. Reconstruction of the inner canthus region with a forehead muscle flap: a report on three cases.We report our experience of using a forehead flap to repair the defect left by the excision of skin tumours in the medial canthal region involving both eyelids in three patients. Both eyelids and the inner canthus were reconstructed using a myofascial flap taken from the forehead, combined with septal chondro-mucosal grafts, oral mucosa and skin grafts. After a careful anatomical study of the vascularisation of the frontal region, we used only the frontal myofascial portion, a part of the forehead muscle vascularised by the deep branch of the supraorbital artery and by the supratroclear artery; the skin left behind is adequately nourished by the fine mesh of anastomoses in the area between the two supratroclear arteries, the supraorbital artery and the terminal vessels of the superficial temporal artery. The particularly thin, elastic and resistant features of this flap enabled us to repair a loss of substance in a difficult area with a successful outcome in terms of morphology, function and cosmetic appearance.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/15. Intravascular lymphomatosis of the lung and liver following eyelid lymphoma in a Chinese man and review of primary pulmonary intravascular lymphomatosis.Intravascular lymphomatosis (IVL) is characterised by an almost exclusive intravascular proliferation of malignant lymphoid cells, with the diagnosis often made only when the illness is in its terminal phase or at autopsy. We detail a case of IVL affecting the lung and liver of a 49-year-old Chinese man presenting primarily with lung symptoms and incidental findings of abnormal serum transaminase levels, the ante-mortem diagnosis being established on transbronchial lung biopsy and percutaneous liver biopsy specimens, respectively. histology disclosed CD20 CD5 - CD10 [corrected] - malignant large mononuclear B cells within the lumina of the blood vessels of the affected organs as well as sinusoids of the liver. Significantly, the patient had a history of large B cell lymphoma affecting the eyelid 18 months prior to the angiotropic disease, suggesting a possible link between the more common types of non-Hodgkin's lymphoma and IVL. A brief review of all cases of primary pulmonary intravascular lymphomatosis is also presented.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/15. Scalping forehead flap for extranasal reconstructions: total reconstruction of the lower lid.J. M. Converse described the scalping forehead flap in 1942 with the aim of using it in total nasal reconstruction. A rich net of arterial and venous vessels constitute the basic pattern of its blood supply through three principal pedicles: (1) temporal superficial, (2) supraorbital, and (3) supratrochlear. It was described for nasal reconstruction, but due to its characteristics, such as color of the frontal skin, texture, hairless skin, and reliable irrigation, it can be used in the reconstruction of other facial areas. According to these particularities, the Converse flap was used in the reconstruction of a total left lower lid and adjacent lateral nose and cheek areas in a patient with an extended squamous carcinoma. The tumoral resection included the removal of (1) complete lower lid, (2) lacrimal lower canaliculus, sac, and nasolacrimal duct, (3) lower ocular conjunctiva, (4) intraorbitary fat and both inferior oblique and inferior rectus muscles, and (5) adjacent skin of the nose and cheek. Postoperative controls showed an excellent aesthetic and functional result. A hypochromic frontal skin graft was the only sequela; definitive skin coloration was obtained by a dermopigmentation technique. The versatility of this forehead flap allows it to be successfully used for reconstruction not only in the nasal area but also in other facial ones.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/15. Solitary eyelid Kaposi sarcoma in an hiv-negative patient.PURPOSE: To describe a case of localized Kaposi sarcoma (KS) of the eyelid in an hiv-seronegative patient. methods: An 80-year-old man developed an ulcerated nodular tumor-like mass that grew rapidly on his left upper eyelid. There were no similar lesions elsewhere. The eyelid lesion was completely excised and histopathologically examined. Serological analyses and molecular biologic techniques, including polymerase chain reaction, were used. RESULTS: Laboratory examinations were within normal limits, and serology for hiv was negative. Histological sections revealed a vascular proliferation composed predominantly of small slit-like blood vessels and epithelioid spindle cells, supporting the diagnosis of KS. polymerase chain reaction was positive for human herpesvirus 8. During a 2-year follow-up, no recurrences, development of new lesions, or hiv seroconversions were observed. CONCLUSION: This is a classic KS involving only the eyelid in an hiv-negative patient. Location in the eyelid is a possible, albeit rare, initial solitary manifestation of KS in elderly hiv-negative patients. Surgery is both safe and effective.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/15. Immunohistochemical staining of sebaceous cell carcinoma of the eyelid.We characterized the inflammatory infiltrate of two sebaceous cell carcinomas of the eyelid with immunohistochemical staining to determine the functional class of the mononuclear cells associated with the tumor. The results were compared with the inflammatory infiltrate associated with basal cell carcinomas. The subepithelial spaces and the area immediately surrounding the sebaceous cell neoplasms were free of mononuclear inflammatory cells, in contrast to the basal cell tumors, which had large numbers of subepithelial inflammatory cells and inflammatory cells in intimate contact with the neoplastic cells as previously reported. Inflammatory reaction in the sebaceous cell tumor was limited to a T-cell infiltrate surrounding the vessels adjacent to the tumor. The predominant mononuclear inflammatory cell in both the sebaceous cell and the basal cell carcinomas was the T helper cell. The apparent difference in mononuclear cell infiltrate may be a significant factor in the clinical behavior of the tumors.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/15. Orbital-adnexal lymphangiomas. A spectrum of hemodynamically isolated vascular hamartomas.A retrospective review of 13 cases of lymphangioma has led to a classification of these lesions into categories of superficial, deep, and combined types. The clinical manifestations, prognosis, and management directly correlate with the pathophysiology and the location of the lesions. Superficial lesions consist of isolated multicystic vascular abnormalities of cosmetic significance only. Deep orbital lymphangiomas present as spontaneous, acute proptosis due to retrobulbar hemorrhage. Combined lesions demonstrate both superficial and deep components and are also characterized by spontaneous hemorrhages. Histopathologically, lymphangiomas represent a spectrum of vascular hamartomas with a constellation of features that parallels the clinical progression and histology of similar lesions elsewhere in the head and neck. This may include the presence of diaphanous serous-filled vascular channels, a connective tissue stroma with lymphorrhages, features of old hemorrhage, dysplastic vessels, and random smooth muscle bundles. Both direct and indirect evidence suggests that these lesions are characterized by relative hemodynamic isolation.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/15. Merkel cell tumour of the eyelid and reconstruction with the Cutler-Beard technique: a clinicopathologic case report.A case of Merkel cell tumour that developed on the left upper lid of a 76-year-old white man is reported. The diagnosis was ultrastructurally made by demonstrating characteristic light microscopic features of Merkel cell carcinoma; such as large, round nuclei and frequent mitoses. Immunohistochemically, the tumour cells were shown to possess simple epithelia-type keratin intermediate filaments. Merkel cell tumour probably develops from precursor cells which give rise to keratinocytes and merkel cells, and nearly one out of 10 Merkel cell tumours occur in the eyelid and periocular region. They tend to be bulging lesions near the lid margin of elderly patients. The condition can be misdiagnosed as lymphoma, oat cell carcinoma, malignant melanoma, sweat gland tumours, neuroblastoma and Ewing's sarcoma, and frequently invades lymphatic vessels. Nearly one out of three Merkel cell tumours recur and two thirds cause regional lymph node metastases. Wide surgical resection and reconstructive procedures, should be followed by routine postoperative irradiation. This patient was treated with wide resection and the Cutler-Beard technique, then scheduled for radiotherapy.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/15. Merkel cell carcinoma of the eyelid.The Merkel cell is part of the dendritic cell population of the epidermis, and studies suggest it has a role as a slowly adapting mechanoreceptor involved with mediating the sense of touch. merkel cells can give rise to malignant neoplasms, one tenth of which occur in the eyelid and periocular area, and manifest as painless erythematous nodules, with overlying telangiectatic blood vessels. Merkel cell carcinoma can mimic other malignant lesions, and the diagnosis can be difficult. One third of the tumors recur, and there is a high rate of metastasis. The estimated 5-year survival rate is 38%. Initial treatment should be aggressive, including surgical resection, with consideration of postoperative radiation. Merkel cell carcinoma responds to chemotherapy, but routinely recurs on cessation of treatment. Two cases are presented to illustrate the typical presentation of Merkel cell carcinoma and the importance of electron microscopy and immunohistochemical studies.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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