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Quigley C, Tong JY, Farshid G, Bonar F, Selva D. Myxoma: An Unusual Aggressive Orbital Lesion. Ophthalmic Plast Reconstr Surg 2024:00002341-990000000-00459. [PMID: 39197176 DOI: 10.1097/iop.0000000000002771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2024]
Abstract
Myxoma is a rare tumor that can be challenging to diagnose, with imaging findings that can be nonspecific. We present a case of a 21-year-old man who presented with a subacute history of right visual deterioration and proptosis. Imaging showed a large right superomedial orbital mass of 43 × 31 × 24 mm, which enhanced heterogeneously and was eroding the adjacent orbital roof and medial wall. An excisional biopsy was performed via a lid crease approach under transorbital endoscopic guidance. We review the clinical, radiological, and histological characteristics of myxoma. In addition, we highlight important associations with genetic syndromes including Carney complex and Mazabraud syndrome.
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Affiliation(s)
- Clare Quigley
- South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia
| | - Jessica Y Tong
- South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia
| | - Gelareh Farshid
- South Australian Pathology, Royal Adelaide Hospital, Adelaide, Australia
| | - Fiona Bonar
- Douglass Hanly Moir Pathology, Macquarie Park, Sydney, Australia
| | - Dinesh Selva
- South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia
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2
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Feng PW, Herskowitz WR, Tang V, Khzam RA, Dubovy SR, Galor A, Karp CL. Characteristics of conjunctival myxomas on anterior segment optical coherence tomography. CANADIAN JOURNAL OF OPHTHALMOLOGY 2024:S0008-4182(24)00180-7. [PMID: 39097290 DOI: 10.1016/j.jcjo.2024.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 04/23/2024] [Accepted: 06/11/2024] [Indexed: 08/05/2024]
Affiliation(s)
- Paula W Feng
- Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, FL
| | | | - Vincent Tang
- Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, FL
| | - Rayan Abou Khzam
- Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, FL
| | - Sander R Dubovy
- Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, FL
| | - Anat Galor
- Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, FL; Department of Ophthalmology, Miami Veterans Administration Medical Center, Miami, FL
| | - Carol L Karp
- Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, FL.
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3
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Matsuo T, Tanaka T. Resection of Orbital Myxoma With Magnetic Resonance Imaging Evidence of Ethmoid Sinus Origin: Case Report and Review of 20 Patients in the Literature. J Investig Med High Impact Case Rep 2023; 11:23247096231201013. [PMID: 37737575 PMCID: PMC10517617 DOI: 10.1177/23247096231201013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/13/2023] [Accepted: 08/27/2023] [Indexed: 09/23/2023] Open
Abstract
A 41-year-old woman showed a palpable mass at the superonasal orbital edge on the right side. Magnetic resonance imaging demonstrated a lobulated fluid-containing tubular mass which extended anteriorly to posteriorly along the medial orbital wall, nasal to the eyeball. She was followed once a year for 8 years until the age of 49 years when she decided to undergo surgical resection because of the enlarged mass. The lobulated large mass was resected and the pathology showed sparsely distributed spindle cells, positive for CD34, in alcian blue-positive mucous substances, indicative of myxoma. Postoperative magnetic resonance imaging showed residual lobulated tubular mass along the optic nerve on the medial side and superior to the eyeball. The residual orbital mass showed stable structure with more evident connection with the ethmoid sinus lesion, suggestive of the ethmoid origin, in 12 years until the age of 61 years. In the review of 20 patients with orbital myxomas in the literature, in addition to this case, roughly classified locations in the orbit were retrobulbar in 8 patients, on the lateral side of the orbit in 4, on the superior side in 6, on the medial side in 1 (this patient), and in the orbit with no specific description in 2. In pathological examinations, immunohistochemistry was not done in 8 patients, done but all negative in 2, and positive in 11 patients: nerve sheath myxoma was diagnosed in 3 patients based on positive S100 staining. Orbital myxoma is rare but considered in differential diagnosis of orbital masses.
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4
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Sabbagh AJ, Arnaout K, Arnaout AY, Toutounji B, Ghabreau L, Ayoub K, Al-Hadid I. Aggressive angiomayxoma in men: Case report and systematic review. Ann Med Surg (Lond) 2022; 79:103880. [PMID: 35860056 PMCID: PMC9289231 DOI: 10.1016/j.amsu.2022.103880] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/23/2022] [Accepted: 05/29/2022] [Indexed: 11/28/2022] Open
Affiliation(s)
| | - Khaled Arnaout
- Faculty of Medicine, University of Aleppo, Aleppo, Syria
| | - Ahmad Yamen Arnaout
- Faculty of Medicine, University of Aleppo, Aleppo, Syria
- Corresponding author. Aleppo University, Faculty of Medicine, Syria.
| | - Bayan Toutounji
- Department of Pulmonology, Faculty of Medicine, Aleppo University, Aleppo, Syria
| | - Lina Ghabreau
- Department of Pathology, Faculty of Medicine, Aleppo University, Aleppo, Syria
| | - Kusay Ayoub
- Instructor at General Surgery Department, Aleppo University Hospital, Aleppo University, Faculty of Medicine, Aleppo, Syria
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Alvarado-Villacorta R, Torres Zavala NM, Marroquín Loayza L, Rodríguez-Reyes AA. Conjunctival myxoma: A systematic review of a rare tumor. Surv Ophthalmol 2021; 67:729-740. [PMID: 34461119 DOI: 10.1016/j.survophthal.2021.08.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 08/19/2021] [Accepted: 08/23/2021] [Indexed: 12/14/2022]
Abstract
Conjunctival myxoma is an uncommon benign tumor that may develop as a localized disease or as part of the Carney complex, in which case it can cause significant morbidity and mortality. Conjunctival myxomas can mimic other pure or mixed tumors and are often overlooked in clinical practice. Histopathological studies are essential for diagnosis; however, controversy regarding their pathological and immunohistochemical features makes the diagnostic process more difficult. Because of the importance of correctly classifying these conjunctival tumors, as well as recognizing when a systematic screening is required owing to the possible association with life-threatening diseases, we comprehensively evaluate the literature on this rare entity based on a systematic approach.
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Affiliation(s)
- Rosa Alvarado-Villacorta
- Cornea and Refractive Surgery Department, Asociación para Evitar la Ceguera en México IAP., Mexico City, Mexico; Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico; Latin American Network for Research in Eye Diseases-LANRED, Mexico City, Mexico.
| | | | - Lelia Marroquín Loayza
- Ocular Pathology Laboratory "Dr. José Antonio Avendaño Valdez," Instituto Nacional de Oftalmología "Dr. Francisco Contreras Campos," Lima, Peru
| | - Abelardo A Rodríguez-Reyes
- Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico; Ophthalmic Pathology Service, Asociación para Evitar la Ceguera en México, I.A.P., Mexico City, Mexico
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6
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Nerve Sheath Myxoma Involving the Medial Rectus Muscle: A Case Report. Ophthalmic Plast Reconstr Surg 2021; 37:e60-e62. [PMID: 32618824 DOI: 10.1097/iop.0000000000001766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A 63-year-old man reported a 2-year history of painless OS proptosis. The first MRI, performed in the institution of origin, resulted in a diagnosis of hemangioma versus orbital pseudotumor. Examination revealed proptosis and mild chemosis. Ancillary tests were normal, and oral prednisone was initiated without remarkable changes. Later, an incisional biopsy identified the lesion as an intramuscular myxoma of the left rectus, and a new MRI was ordered. It described a fusiform thickening of the medial rectus with and exophytic growth below the inferior rectus and upward toward the superior oblique. Due to the localization of the lesion, a combined transcaruncular and swinging eyelid approach with a lateral orbitotomy was performed. Histopathological examination revealed a proliferation of stromal origin composed of myxoid matrix with fusocellular and stellate-shaped cells. Cells were S-100, CD34, and CD56 positive and negative for epithelial membrane antigen, CD68, CD10, actin, and desmin. Results were consistent with a left medial rectus nerve sheath myxoma.
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Weisbrod L, Smith K, Camarata P, Alvarado A, Andrews B. Orbital myxoma: A case report. Surg Neurol Int 2020; 11:43. [PMID: 32257569 PMCID: PMC7110406 DOI: 10.25259/sni_323_2019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 02/22/2020] [Indexed: 11/14/2022] Open
Abstract
Background: Myxomas are rare, locally infiltrative, benign neoplasms of mesenchymal origin. Although benign, these tumors are locally aggressive with a high rate of recurrence following conservative resection. Their relative infrequency, variable location, and insidious growth present a diagnostic challenge to clinicians. Cases of myxomas have been described throughout the body, but intraosseous myxomas of the orbit are exceedingly rare. Case Description: We report a case of a 53-year-old male with a history of chronic sinusitis and symptoms of hyposmia and bifrontal headaches refractory medical management who presented for neurosurgical evaluation after radiographic findings of an orbital lesion. Physical examination was unremarkable with intact extraocular movements. Prior radiographic workup demonstrated a 2.4 × 2.7 × 2.2 cm expansile lesion involving the bony left superior and lateral orbit. A prior open biopsy was performed which demonstrated a low-grade spindle cell neoplasm consistent with intraosseous myxoma. Definitive resection was recommended through the left orbitozygomatic craniotomy. The patient tolerated the procedure well without complications. Gross total resection was achieved. Reconstruction of the orbital roof and lateral orbital wall was performed with a frontal bone autograft and titanium plating. Postoperative course was uneventful, and the patient was discharged home postoperative day 2. At 1-month follow-up visit, the patient remained neurologically intact. Surveillance imaging at 6 months and 1 year remained stable without signs of recurrence. Conclusion: Intraosseous orbital myxomas are exceedingly rare entities. Although they are considered benign neoplasms, myxomas demonstrate high recurrence rates. The authors report a unique case of an orbital myxoma that was successfully treated through an orbitozygomatic approach achieving gross total resection.
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Affiliation(s)
- Luke Weisbrod
- Department of Neurosurgery, University of Kansas Health System, Kansas City, Kansas
| | - Kyle Smith
- Department of Neurological Surgery, University of Kansas Medical Center, Kansas City, Kansas
| | - Paul Camarata
- Department of Neurosurgery, University of Kansas Health System, Kansas City, Kansas
| | - Anthony Alvarado
- Department of Neurosurgery, University of Kansas Health System, Kansas City, Kansas
| | - Brian Andrews
- Department of Plastic Surgery, University of Kansas Medical Center, Kansas City, Kansas
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8
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Hussnain SA, Sung S, Remotti F, Schubert H, Chang S, Marr B. Ciliary Body Myxoma in a 20-Year-Old Woman. JAMA Ophthalmol 2019; 137:464-466. [PMID: 30653213 DOI: 10.1001/jamaophthalmol.2018.6678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- S Amal Hussnain
- Edward S. Harkness Eye Institute, Department of Ophthalmology, Columbia University Vagelos College of Physicians and Surgeons, New York, New York.,Vitreous Retina Macula Consultants of New York, New York.,Department of Ophthalmology, New York University School of Medicine, New York
| | - Simon Sung
- Department of Pathology and Cell Biology, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Fabrizio Remotti
- Department of Pathology and Cell Biology, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Hermann Schubert
- Edward S. Harkness Eye Institute, Department of Ophthalmology, Columbia University Vagelos College of Physicians and Surgeons, New York, New York.,Department of Pathology and Cell Biology, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Stanley Chang
- Edward S. Harkness Eye Institute, Department of Ophthalmology, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Brian Marr
- Edward S. Harkness Eye Institute, Department of Ophthalmology, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
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9
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Manjandavida FP, Chahar S, Dave B. Isolated intraosseous extra-gnathic orbital myxoma: a clinicopathologic case report. Orbit 2018; 38:401-406. [PMID: 30489165 DOI: 10.1080/01676830.2018.1538381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
A 19-year-old female student presented with painless, progressive proptosis in the right eye for the past six months causing significant cosmetic blemish and double vision. Clinical evaluation revealed normal visual acuity, normal pupillary reflex, severe proptosis, and dystopia. Orbital imaging revealed a heterogeneous mass in superior orbit displacing the globe inferiorly and causing extensive bony erosion of frontal bone superiorly and invading the frontal sinus. Excision biopsy was performed with en-bloc removal of the tumor. Surgical delivery of a slimy mass with infiltrated bony tissue led to a presumptive diagnosis of myxoid liposarcoma. Careful histopathologic analysis coupled with immunohistochemical studies were performed which established the rare diagnosis of low-grade myxoid spindle cell neoplasm with features suggestive of intraosseous myxoma. On follow-up at 15 months, our patient revealed no signs of recurrence. Isolated intraosseous orbital myxoma is a rare entity; only two such cases have been reported in the literature.
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Affiliation(s)
- Fairooz P Manjandavida
- Department of Oculoplasty, Orbit and Ocular Oncology, HORUS Specialty Eye Care , Bangalore , India
| | - Shaifali Chahar
- Department of Oculoplasty, Orbit and Ocular Oncology, HORUS Specialty Eye Care , Bangalore , India
| | - Brijal Dave
- Department of Pathology, Majumdar Shaw Cancer Center, Narayana Health City , Bangalore , India
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10
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Fibromyxoma of the Orbit. J Craniofac Surg 2018; 30:e19-e21. [PMID: 30444783 DOI: 10.1097/scs.0000000000004950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Fibromyxomas are rare tumors that are not commonly seen in the orbit. The authors present a case of orbital fibromyxoma. A 42-year-old male presented with proptosis of the right eye that began 1 month prior. Magnetic resonance imaging revealed the presence of an orbital mass in the right eye, with low signal intensity on T1-weighted images and heterogeneous high-signal intensity on T2-weighted images. The patient underwent excisional biopsy of the orbital tumor through a Krönlein approach. The tumor originated from the inferior rectus muscle. Histopathologic analysis demonstrated scattered spindle cells, with both fibrous and myxoid stroma. Immunohistochemical staining was positive for Vimentin and negative for S-100 protein and CD34. The tumor was diagnosed as orbital fibromyxoma. The patient showed no evidence of recurrence over 18 months of follow-up after operation.
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11
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Pujari A, Bajaj MS, Sen S, Goel S. Conjunctival angiomyxoma-rare but needs observation. Can J Ophthalmol 2018; 53:e60-e62. [PMID: 29631843 DOI: 10.1016/j.jcjo.2017.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 06/24/2017] [Accepted: 07/04/2017] [Indexed: 11/18/2022]
Affiliation(s)
- Amar Pujari
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
| | - Mandeep S Bajaj
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Seema Sen
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Siddhi Goel
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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12
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Abstract
Myxomas are rare neoplasms of mesenchymal origin. Cases of conjunctival, corneal, and orbital myxomas have been reported in the literature; however, to the best of our knowledge, there is no report of a lacrimal gland myxoma. We report a case of an orbital myxoma involving the lacrimal gland and its management.
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Affiliation(s)
- Drushti Parikh
- Department of Orbit, Oculoplasty, Reconstructive and Aesthetics, Sankara Nethralaya, Medical Research Foundation, Chennai, Tamil Nadu, India
| | - Bipasha Mukherjee
- Department of Orbit, Oculoplasty, Reconstructive and Aesthetics, Sankara Nethralaya, Medical Research Foundation, Chennai, Tamil Nadu, India
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13
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Rodríguez-Cabrera L, Zuazo F, Schneider-Ehrenberg O, Moreno-García A, Tovilla-Canales JL. Mixoma orbitario. Reporte de un caso inusual. REVISTA MEXICANA DE OFTALMOLOGÍA 2017. [DOI: 10.1016/j.mexoft.2016.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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14
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Extragnathic sino-orbital myxoma: an extremely rare tumor at an even rarer site. Ophthalmic Plast Reconstr Surg 2015; 30:e157-9. [PMID: 24833439 DOI: 10.1097/iop.0000000000000002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Myxomas are rare benign tumors of primitive mesenchymal origin that usually arise from the soft tissues and occasionally from the bones. Bony myxomas predominantly arise from the jaw bone and hence are also known as gnathic myxomas. Any other bony myxomas are termed as extragnathic. In view of rarity, uncertain histogenesis, nonspecific clinical features, confusing terminology, and unclear management protocols, the backbone of diagnosis is a thorough histopathologic examination. Only 2 reports on myxomas arising from the frontal sinus have been documented previously. A young man presented with proptosis secondary to a sino-orbital mass lesion arising from the frontal sinus. The patient underwent complete excision biopsy and bone curettage. Following excision, the patient is symptom free at 6 months of follow up and showed no evidence of recurrence.
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15
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Jakobiec FA, Callahan AB, Stagner AM, Lee NG, Rashid A, Mendoza P, Grove A, Freitag SK. Malignant rhabdoid transformation of a longstanding, aggressive, and recurrent orbital angiomyxoma. Surv Ophthalmol 2015; 60:166-76. [DOI: 10.1016/j.survophthal.2014.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 12/04/2014] [Accepted: 12/09/2014] [Indexed: 10/24/2022]
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16
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De Niro JE, Cham EM, Silkiss RZ. Undifferentiated sarcoma of the orbit with angiomyxoid features. J Pediatr Ophthalmol Strabismus 2014; 51 Online:e4-7. [PMID: 25314104 DOI: 10.3928/01913913-20140218-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Accepted: 01/06/2014] [Indexed: 11/20/2022]
Abstract
A 7-month-old female infant developed a grade 3 un-differentiated sarcoma with angiomyxoid features of the right orbit. The tumor expanded rapidly 2 months after an initial sub-total resection and extended posteriorly toward the right cavernous sinus. After treatment with ifosphamide, doxorubicin, and proton beam radiation, there was no discernible residual tumor 20 months after starting chemotherapy.
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Abstract
Orbital myxomas are extremely rare tumors. We describe a 75-year old male patient with lower eyelid ectropion and 8-mm of left non-axial proptosis. Orbital CT and MRI revealed a well-demarcated lesion in the lateral quadrant of the orbit. After complete surgical excision, histopathological examination led to the diagnosis of orbital myxoma. The patient was followed-up for 1 year without recurrence.
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Affiliation(s)
- Hatem A Tawfik
- Oculoplastics Service, Ain Shams University, Cairo, Egypt.
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18
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Mishulin A, Lever JF, Porter W, Servat JJ, Gladstone G, Black E. Aggressive glabellar angiomyxoma with orbital extension. Orbit 2012; 31:361-3. [PMID: 22974117 DOI: 10.3109/01676830.2012.710925] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
A 62-year-old male presented with a large non-tender mass in the glabella, extending into the right orbit that had been steadily growing for 6 months. Imaging revealed a 2.5 x 1.8 cm cystic mass with extension into the right anterior orbit. Biopsy with microscopic examination revealed a predominantly myxoid stroma containing spindle-shaped cells with bipolar cigar-shaped nuclei and small caliber capillary-type vascular proliferations. These findings are consistent with an angiomyxoma. Although angiomyxomas typically present in the pelvic region or peritoneum in female patients, there have been rare examples of angiomyxomas with orbital involvement.
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Belliveau MJ, Liao WN, Brownstein S, Manusow JS, Jordan DR, Gilberg S, Mintsioulis G. Myxomatous corneal degeneration: a clinicopathological study of six cases and a review of the literature. Surv Ophthalmol 2012; 57:264-71. [PMID: 22370508 DOI: 10.1016/j.survophthal.2011.09.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2011] [Revised: 09/16/2011] [Accepted: 09/20/2011] [Indexed: 11/18/2022]
Abstract
Thirteen cases with myxomatous changes of the corneal stroma have been reported to date. We report six additional cases with clinical, histopathological, and immunohistochemical data. The clinical appearance is most often a gelatinous, whitish elevation with insidious onset. Histopathologically, there are inconspicuous spindle- and stellate-shaped cells in a loose, myxoid matrix. The typical location is in the anterior cornea beneath the epithelium, with varying degrees of extension into the stroma. Vimentin and smooth-muscle actin immunohistochemical stains are characteristically positive, and staining occasionally may be seen with muscle-specific actin, whereas CD34 staining usually is negative. In most cases, myxomatous changes are a degenerative process involving transformation of stromal keratocytes into cells with prominent secretory activity and myofibroblastic differentiation. Most occur in corneas with a history of ocular disease or trauma that disrupts Bowman's layer. We suggest labelling lesions with these features as "myxomatous corneal degeneration." So-called "primary corneal myxomas" also exist where there is no significant history. It remains unclear whether the myxomatous changes in such lesions are neoplastic or degenerative. Myxomatous corneal changes are likely under-recognized and under-diagnosed.
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Affiliation(s)
- Michel J Belliveau
- Department of Ophthalmology, University of Ottawa Eye Institute and The Ottawa Hospital, Ottawa, Ontario, Canada
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21
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Bielory B, Mirani N, Barry M, Turbin R. Radiographic and histological findings in an atypical orbital myxoma. OPHTHALMOLOGY AND EYE DISEASES 2011; 3:55-9. [PMID: 23861624 PMCID: PMC3661435 DOI: 10.4137/oed.s7498] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Myxomas are rare neoplasms of mesenchymal origin. Diagnostic evaluation requires histopathological confirmation. We report a rare case of atypical orbital myxoma with radiographic and histopathological correlation.
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Affiliation(s)
- Bp Bielory
- Research Fellow, Bascom Palmer Eye Institute, University of Miami, Miami, Florida
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Abstract
A 72-year-old man was referred to the Service of Ophthalmology due to a 2-year history of ptosis and a painless mass in the lateral orbital margin of the right eye. Orbital MRI revealed a well-demarcated lesion in the superotemporal quadrant of the orbit. After surgical excision, histopathological examination led to the diagnosis of nerve sheath myxoma, a tumor composed of myxoid nodules separated by fibrous septa with spindle-shaped and stellate cells. Many of these cells were immunostained with antibodies to S-100 protein. This is the first case reported in the literature of such a tumor located in the orbit, and, though extremely rare, it should be considered in the differential diagnosis of orbital tumors.
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24
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Gajanayake I, Priestnall SL, Benigni L, English K, Summers BA, Garden OA. Paraneoplastic hypercalcemia in a dog with benign renal angiomyxoma. J Vet Diagn Invest 2010; 22:775-80. [PMID: 20807942 DOI: 10.1177/104063871002200523] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
An 11-year-old, male, neutered crossbred Collie dog was presented for a history of polydipsia and polyuria. Diagnostic investigations revealed total and ionized hypercalcemia and an increased concentration of parathyroid hormone-related peptide. Abdominal ultrasonography and contrast-enhanced computed tomography of the abdomen revealed a right-sided, cystic-appearing renal mass. Cytological examination of ultrasound-guided aspirates of the mass revealed high numbers of spindle cells. The mass was removed en bloc via an ureteronephrectomy. Histopathological examination of the mass revealed neoplastic spindle cells in loosely packed and interlacing streams within a myxomatous stroma. Immunohistochemical examination with vimentin, von Willebrand Factor, and alpha-smooth muscle actin confirmed the mass to be a renal angiomyxoma. A minority of the neoplastic spindle cells showed positive cytoplasmic parathyroid hormone-related peptide immunostaining. The hypercalcemia resolved following surgery, and the parathyroid hormone-related peptide concentration returned to within the reference interval. The dog was no longer polydipsic or polyuric 1 year following surgery. The present report describes a previously unreported renal neoplasm causing paraneoplastic hypercalcemia and highlights the possibility of paraneoplastic hypercalcemia being caused by a benign neoplasm.
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Affiliation(s)
- Isuru Gajanayake
- Department of Veterinary Clinical Sciences, The Royal Veterinary College, North Mymms, Hatfield, Hertfordshire, United Kingdom.
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25
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Affiliation(s)
- Jong Hoon Shin
- Department of Ophthalmology, Pusan National University School of Medicine, Busan, Korea
| | - Jae Ho Jung
- Department of Ophthalmology, Pusan National University School of Medicine, Busan, Korea
| | - Hee Young Choi
- Department of Ophthalmology, Pusan National University School of Medicine, Busan, Korea
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Satter EK. Solitary superficial angiomyxoma: an infrequent but distinct soft tissue tumor. J Cutan Pathol 2009; 36 Suppl 1:56-9. [DOI: 10.1111/j.1600-0560.2008.01216.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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