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Zhang W, Rokohl AC, Guo Y, Yao K, Fan W, Heindl LM. Global incidence and prevalence of malignant orbital tumors. ADVANCES IN OPHTHALMOLOGY PRACTICE AND RESEARCH 2024; 4:128-133. [PMID: 38952566 PMCID: PMC11215945 DOI: 10.1016/j.aopr.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 03/18/2024] [Accepted: 04/10/2024] [Indexed: 07/03/2024]
Abstract
Purpose Aims to provide an overview of the contemporary epidemiology of malignant orbital tumors by analyzing population-based incidence patterns across various regions worldwide. Methods In this article, we retrieved orbital malignancy data from the MEDLINE database and analyzed the incidence and prevalence of orbital malignancies worldwide. We performed the literature search by searching on the Mesh terms for malignant orbital tumors ("orbital", "tumor", "lymphoma", "malignant", "cancer", "incidence", and "epidemiology"). All included studies were published between 1993 and 2023 and were written in English. Results Ocular or ophthalmic lymphoma most frequently occurred in the orbit, with a prevalence ranging from 47% to 54%. The incidence of malignant orbital tumors was increasing in the USA (2.0 per million (1981-1993), Netherlands (0.86 (1981-1985) to 2.49 (2001-2005) per million) and South Korea (0.3-0.8 per million (1999-2016)), respectively. Ophthalmic lymphoma which includes orbit lymphoma was increasing in Canada (0.17-1.47 per million (1992-2010)), Denmark (0.86 per million (1981-1985) to 2.49 per million (2001-2005)), respectively. Conclusions The predominant primary malignant orbital tumor in adults was lymphoma. Ocular or ophthalmic lymphoma most frequently occured in the orbit. The limited data available suggested an increasing trend in the incidence of malignant orbital tumors in each country included, which were mainly attributed to the increase in lymphoma. Generally, incidence rates were found to increase with advancing age, with no difference between males and females.
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Affiliation(s)
- Weina Zhang
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Alexander C. Rokohl
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Center for Integrated Oncology (CIO), Aachen-Bonn-Cologne-Duesseldorf, Cologne, Germany
| | - Yongwei Guo
- Eye Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Ke Yao
- Eye Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Wanlin Fan
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Ludwig M. Heindl
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Center for Integrated Oncology (CIO), Aachen-Bonn-Cologne-Duesseldorf, Cologne, Germany
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Fan C, Liu Y, Gong Q, Zhou C, Qiao C. Synthesis and Characterization of SiO 2/nGO/Fe 3O 4/SeQDs Nanoparticles as Potential Nanocarriers in Drug Delivery Systems. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2024; 40:12792-12801. [PMID: 38848468 DOI: 10.1021/acs.langmuir.4c01376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2024]
Abstract
Herein, we constructed the branch-shaped SiO2/nano GO (nGO)/Fe3O4/selenium quantum dots (QDs) (SeQDs) nanoparticles (SGF/SeQDs) embodying magnetism, fluorescence, and microwave stimulus response properties to enhance the performance of releasing drugs. The SGF/SeQDs composite was characterized by technologies including powder X-ray diffraction, transmission electron microscopy, infrared spectroscopy, etc. In the nanoparticles, the branch-shaped SiO2 provides a large specific surface area, nGO as the dielectric loss-style material promotes microwave-absorbing performance, and the Fe3O4 serves as a magnetic targeting agent and microwave absorber. Integrating nGO and Fe3O4 could further strengthen the microwave absorption of the entire composite; selenium features both fluorescence and anticancer effects. The synthesized nanoparticles as carriers exhibited a branch-like mesoporous sphere of ∼260 nm, a specific surface area of 258.57 m2 g-1, a saturation magnetization of 24.59 emu g-1, and good microwave thermal conversion performance that the temperature was elevated from 25 to 70 °C under microwave irradiation. These physical characteristics, including large pore volume (5.30 nm), high specific surface area, and fibrous morphology, are in favor of loading drugs. Meanwhile, the cumulative etoposide (VP16) loading rate of the nanoparticles reached to 21 wt % after 360 min. The noncovalent interaction between the VP16 and SGF/SeQDs was mainly the hydrogen-bonding effect during the loading process. Furthermore, the drug release rates at 180 min were up to 81.46, 61.92, and 56.84 wt % at pH 4, 5, and 7, respectively. At 25, 37, and 50 °C, the rates of drug release reach 25.40, 56.84, and 65.32 wt %, respectively. After microwave stimulation at pH 7, the rate of releasing drug increased distinctly from 56.84 to 71.74 wt % compared to that of nonmicrowave irradiation. Cytotoxicity tests manifested that the carrier had good biocompatibility. Therefore, the nanoparticles are looking forward to paving one platform for further applications in biomedicine and drug delivery systems.
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Affiliation(s)
- Chaochao Fan
- Shaanxi Key Laboratory of Comprehensive Utilization of Tailings Resources, College of Chemical Engineering and Modern Materials, Shangluo University, Shangluo 726000, P. R. China
- Shaanxi Engineering Research Center for Mineral Resources Clean & Efficient Conversion and New Materials, Shangluo University, Shangluo 726000, P. R. China
| | - Ye Liu
- College of Freshman, Xi'an Technological University, Xi'an 710021, P. R. China
| | - Qiuyu Gong
- Department of Thoracic Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710049, P. R. China
| | - Chunsheng Zhou
- Shaanxi Key Laboratory of Comprehensive Utilization of Tailings Resources, College of Chemical Engineering and Modern Materials, Shangluo University, Shangluo 726000, P. R. China
- Shaanxi Engineering Research Center for Mineral Resources Clean & Efficient Conversion and New Materials, Shangluo University, Shangluo 726000, P. R. China
| | - Chengfang Qiao
- Shaanxi Key Laboratory of Comprehensive Utilization of Tailings Resources, College of Chemical Engineering and Modern Materials, Shangluo University, Shangluo 726000, P. R. China
- Shaanxi Engineering Research Center for Mineral Resources Clean & Efficient Conversion and New Materials, Shangluo University, Shangluo 726000, P. R. China
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Alfaar AS, Yousef YA, W Wilson M, Hassanain O, Kakkassery V, Moustafa M, Kunbaz A, Esmael A, Strauß O. Declining incidence and improving survival of ocular and orbital lymphomas in the US between 1995 and 2018. Sci Rep 2024; 14:7886. [PMID: 38570585 PMCID: PMC10991268 DOI: 10.1038/s41598-024-58508-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 03/30/2024] [Indexed: 04/05/2024] Open
Abstract
This epidemiological study examined ocular and orbital lymphomas in the United States from 1995 to 2018, using data from the North American Association of Central Cancer Registries database of 87,543 patients with ocular and adnexal malignancies. We identified 17,878 patients (20.4%) with ocular and orbital lymphomas, with an age-standardized incidence rate (ASIR) of 2.6 persons per million (ppm). The incidence was the highest in the orbit (ASIR = 1.24), followed by the conjunctiva (ASIR = 0.57). Non-Hodgkin B-cell lymphoma was the most prevalent subtype (85.4%), particularly marginal-zone lymphoma (45.7%). Racial disparities were noted, with Asia-Pacific Islanders showing the highest incidence (orbit, 1.3 ppm). The incidence increased significantly from 1995 to 2003 (Average Percent Change, APC = 2.1%) but declined thereafter until 2018 (APC = - 0.7%). 5-year relative survival (RS) rates varied, with the highest rate for conjunctival lymphoma (100%) and the lowest for intraocular lymphoma (70.6%). Survival rates have generally improved, with an annual increase in the 5-year RS of 0.45%. This study highlights the changing epidemiological landscape, pointing to initial increases and subsequent decreases in incidence until 2003, with survival improvements likely due to advancements in treatment. These findings underscore the need for further research to investigate the root causes of these shifts and the declining incidence of ocular lymphoma.
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Affiliation(s)
- Ahmad Samir Alfaar
- Medical Neuroscience PhD Program, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität, Berlin Institute of Health, Humboldt-University, 10117, Berlin, Germany.
- Department of Ophthalmology, The Royal Liverpool University Hospital, Liverpool, UK.
| | - Yacoub A Yousef
- Department of Surgery/Ophthalmology, King Hussein Cancer Center, Amman, Jordan
| | - Matthew W Wilson
- St. Jude Children's Research Hospital, Memphis, TN, USA
- Department of Ophthalmology, University of Tennesse Health Science Center, Hamilton Eye Institute, Memphis, TN, USA
| | - Omneya Hassanain
- Research Department, Children's Cancer Hospital -Egypt, 57357, Cairo, Egypt
| | - Vinodh Kakkassery
- Ophthalmology Department, University Hospital of Schleswig-Holstein, Lübeck, Germany
- Ophthalmology Department, Klinikum Chemnitz, Chemnitz, Germany
| | - Mohanad Moustafa
- Ophthalmology Department, University Hospital Hairmyres, East Kilbride, Scotland, UK
| | - Ahmad Kunbaz
- Ophthalmology Department, Istanbul Medeniyet University, Istanbul, Turkey
| | - Amanne Esmael
- Ophthalmology Department, Cairo University, Cairo, Egypt
| | - Olaf Strauß
- Experimental Ophthalmology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität, Berlin Institute of Health, Humboldt-University, 10117, Berlin, Germany
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Vijay V, Alam MS, Subramanian N, Krishnakumar S, Biswas J, Mukherjee B. Clinical spectrum and clinicopathological correlation of pediatric orbital tumors: 20 years' experience from a tertiary eye care center. Indian J Ophthalmol 2024; 72:249-257. [PMID: 38099389 PMCID: PMC10941950 DOI: 10.4103/ijo.ijo_495_23] [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: 02/17/2023] [Revised: 09/22/2023] [Accepted: 09/26/2023] [Indexed: 12/19/2023] Open
Abstract
PURPOSE To study the epidemiological profile of various pediatric orbital tumors and determine their clinicopathological correlation over 20 years. METHODS A retrospective analysis of all pediatric patients with orbital tumors from the medical records between 1995 and 2015 was done. Tumors were categorized based on their cellular origin. Demographic details, clinical and histopathological diagnoses, frequency, and clinicopathological correlation were studied. RESULTS A total of 265 pediatric patients with orbital tumors were analyzed, of which 145 (54.7%) patients were males and 120 (45.3%) were females. The mean age was 7 years (median: 6 years; range: 10 days-16 years). The distribution of lesions in each group was as follows: vasculogenic, 76 (28.7%); lipogenic and myxoid, 66 (25%); myogenic, 31 (11.7%); optic nerve and meningeal, 22 (8.3%); lymphoid and lymphoproliferative, 18 (6.8%); secondary orbital tumors, 14 (5.2%); histiocytic, 9 (3.4%); miscellaneous, 9 (3.4%), lacrimal gland, 8 (3%); mesenchymal with neural differentiation, 6 (2%); osseous, 4 (1.5%), and fibrocystic, 2 (0.8%). The most common benign and malignant pediatric orbital tumors were dermoid cysts (65, 24.5%) and rhabdomyosarcoma (31, 11.7%). A statistically significant ( P < 0.0001) clinicopathological correlation was observed in 208 (83.2%) out of 250 biopsy-proven cases. CONCLUSION Pediatric orbital neoplasms include a broad spectrum of benign and malignant lesions. Vasculogenic tumors constitute the majority of them, followed by lipogenic and myxoid tumors. A thorough knowledge of the incidence, clinical profile, imaging features, and histopathology of specific orbital tumors aids in accurate diagnosis and their successful management.
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Affiliation(s)
- Vathsalya Vijay
- Orbit, Oculoplasty, Reconstructive and Aesthetic Services, Sankara Nethralaya, Medical Research Foundation, Chennai, Tamil Nadu, India
| | - Md. Shahid Alam
- Orbit, Oculoplasty, Reconstructive and Aesthetic Services, Aditya Birla Sankara Nethralaya, Kolkata, (A Unit of Medical Research Foundation, Chennai), West Bengal, India
| | - Nirmala Subramanian
- Orbit, Oculoplasty, Reconstructive and Aesthetic Services, Sankara Nethralaya, Medical Research Foundation, Chennai, Tamil Nadu, India
| | - Subramanian Krishnakumar
- Larson and Toubro Department of Ocular Pathology, Sankara Netherlaya, Vision Research Foundation, Chennai, Tamil Nadu, India
| | - Jyotirmay Biswas
- Larson and Toubro Department of Ocular Pathology, Sankara Netherlaya, Vision Research Foundation, Chennai, Tamil Nadu, India
| | - Bipasha Mukherjee
- Orbit, Oculoplasty, Reconstructive and Aesthetic Services, Sankara Nethralaya, Medical Research Foundation, Chennai, Tamil Nadu, India
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Alghamdi AH, Ahmed AA, Abdalgadir H, Bashir M, Khalid A, Abdalla AN, Elzubier ME, Adnan Almaimani R, Refaat B, Alzahrani K, Alghamdi SM, Gul S. In-vitro Cytotoxicity Investigations for Phytoconstituents of Saudi Medicinal Plants With Putative Ocular Effects. Integr Cancer Ther 2024; 23:15347354241256649. [PMID: 38819027 PMCID: PMC11143859 DOI: 10.1177/15347354241256649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 04/20/2024] [Accepted: 05/06/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Metastatic secondary ocular tumors spread from systemic malignancies, including breast cancer. This study aimed to evaluate the cytotoxicity of extracts from 5 medicinal plants native to Saudi Arabia. METHODS For preliminary activity screening, cytotoxicity using the MTT assay and selectivity index determinations were made for medicinal plant extracts against various cancer cell-lines. The most promising extract was subjected to GC-MS analysis to determine the phytochemical composition. Clonogenic assays were performed using the most promising extract to confirm the initial results. Finally, western blot analysis was used to determine the modulation in expression of survivin and P27 suppressor genes in the human breast adenocarcinoma (MCF7) cell-line to understand the potential mechanistic properties of the active plant extract. RESULTS The 5 plant extracts showed various cytotoxic activity levels using IC50. The most active extract was found to be the leaves of Capparis spinosa L. (BEP-07 extract) against the MCF7 breast cancer cell-line (IC50 = 3.61 ± 0.99 μg/ml) and selectivity index of 1.17 compared to the normal human fetal lung fibroblast (MRC5) cells. BEP-07 extract showed a dose dependent clonogenic effect against the MCF7 colonies which was comparable with the effect of doxorubicin. BEP-07 extract caused a significant decrease of survivin and increase in P27 expression compared to control GAPDH at its highest dose (14 µg/ml). The GC-MS chromatogram of Capparis spinosa L. (BEP-07 extract) revealed the existence of 145 compounds, belonging to the diverse classes of phytoconstituents. Fatty acids and their derivatives represent 15.4%, whilst octadecanoic acid, 2,3-dihydroxypropyl ester was the principal component (7.9%) detected. CONCLUSION Leaves of Capparis spinosa L. (BEP-07 extract) exhibited a significant cytotoxic effect particularly against breast cancer cells. It exhibited this effect through survivin inhibition and via P27 upregulation. The detected phytoconstituents in the plant extract might be involved in tested cytotoxic activity, while further investigations are required to complete the drug candidate profile.
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Affiliation(s)
| | - Aimun A.E. Ahmed
- Al Baha University, Al Baha, Saudi Arabia
- Omdurman Islamic University, Khartoum, Sudan
| | | | | | | | - Ashraf N. Abdalla
- Umm Al-Qura University, Makkah, Saudi Arabia
- National Center for Research, Khartoum, Sudan
| | | | | | | | | | | | - Sheraz Gul
- Fraunhofer Institute for Translational Medicine and Pharmacology, Hamburg, Germany
- Fraunhofer Cluster of Excellence for Immune-Mediated Diseases CIMD, Hamburg, Germany
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Bagheri A, Ashtar-nakhaie P, Aletaha M, Kheiri B, Veisi A. A Survey on Orbital Space-Occupying Lesions during a Twelve-Year Period from a Referral Center in Iran. J Ophthalmic Vis Res 2023; 18:202-211. [PMID: 37181606 PMCID: PMC10172800 DOI: 10.18502/jovr.v18i2.13187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 01/04/2023] [Indexed: 05/16/2023] Open
Abstract
Purpose In this study, we describe different orbital space-occupying lesions (SOLs) from a referral center in Iran. Methods In this retrospective case series, all records of "orbital tumors" with a definite histopathologic diagnosis at a referral center in Iran were reviewed from April 2008 to May 2020. Results A total of 375 orbital SOLs were included. The study population consisted of 212 (56.5%) female and 163 (43.5%) male subjects with overall mean age of 31.09 ± 21.80 years. The most common clinical presentation was proptosis and the superotemporal quadrant was the most frequent site of involvement. Extraconal lesions (276 cases, 73.6%) outnumbered intraconal lesions (99 cases 26.4%). The great majority of SOLs (344, 91.7%) were primary, while 24 (6.4%) were secondary and 7 (1.9%) were metastatic. Benign lesions (309, 82.4%) were much more common than malignant SOLs (66, 17.6%). Overall, dermoid cysts and malignant lymphoma were the most prevalent benign and malignant orbital SOLs, respectively. The malignant to benign lesion ratio was 0.46 in children (≤18 years), 0.81 in middle-aged subjects (19-59 years), and 5.9 in older (≥60 years) cases. The most common type of malignancy was rhabdomyosarcoma in children, lymphoma in middle-aged subjects, and invasive basal cell carcinoma in older age group. Conclusion Over the 12-year study period, benign, primary, extraconal orbital SOLs were more frequent than malignant, secondary, and intraconal lesions. The ratio of malignant lesions increased with age in this cohort of patients.
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Affiliation(s)
- Abbas Bagheri
- Ocular Tissue Engineering Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parisa Ashtar-nakhaie
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Aletaha
- Ocular Tissue Engineering Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahareh Kheiri
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amirreza Veisi
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Saakyan SV, Sklyarova NV, Tsygankov AY, Zhiltsova MG, Alikhanova VR, Tatskov RA. Orbital rhabdomyosarcoma in children. RUSSIAN OPHTHALMOLOGICAL JOURNAL 2022. [DOI: 10.21516/2072-0076-2022-15-4-77-83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Purpose. To analyze the results of treatment and active monitoring the children with orbital rhabdomyosarcoma (RMS) with an emphasis on vital prognosis. Material and methods. We examined 32 children with RMS (18 boys, 14 girls) aged 2 months to 12 years, whose case history ranged from 1 week to 16 weeks (median, 5 weeks). The median follow-up was 60 months. The tumor was localized in the upper (n = 13), upper internal (n = 9), lower (n = 4), internal (n = 3), and external (n = 3) quadrants. The patients underwent primary surgical treatment: orbitotomy using transcutaneous (n = 26), transconjunctival (n = 2) and subperiosteal access (n = 4) followed by cytological, histological and immunohistochemical tissue verification in all cases. Results. The highest number of RMS cases was noted in in the 2- to 7-year-old group (66 % of patients). All patients were treated in in-patient settings. Complete macroscopic removal of tumor was performed in 17 cases, partial removal in 9 cases, and biopsy sampling in 6 cases. The embryonic type of RMS accounted for 87 % (n = 28), and the alveolar type, for 13 % (n = 6). In the postoperative period all children received combined therapy (systemic polychemotherapy and distant radiation therapy) in in-patient facilities of special oncological and radiological clinics. The survival rate of the whole group was 100%. In the long-term follow-up period (after 3 to 5 years), reconstructive surgeries were performed to correct ptosis and strabismus, and/or spectacle or prismatic correction of complex or mixed astigmatism. In cases of “dry” eye syndrome, conservative local therapy was offered. After orbital exenteration, ectoprosthesis procedures was applied. Conclusion. The analysis of our observations of 32 children with orbital rhabdomyosarcoma showed a 100 % survival rate, which testifies to the importance of timely diagnosis and combined treatment of the tumor.
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Affiliation(s)
- S. V. Saakyan
- Helmholtz National Medical Research Center of Eye Diseases; Yevdokimov Moscow State Medical Stomatological University of Medicine and Dentistry
| | | | - A. Yu. Tsygankov
- Helmholtz National Medical Research Center of Eye Diseases; Yevdokimov Moscow State Medical Stomatological University of Medicine and Dentistry
| | | | | | - R. A. Tatskov
- Helmholtz National Medical Research Center of Eye Diseases
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Al-Mujaini A, Maurya RP, Bosak S, Karan MK, Roy M, Singh VP, Singh MK, Kumar A, Singh S. Clinicopathological Analysis and Demographic Features of Ocular Malignancies. Clin Ophthalmol 2021; 15:357-365. [PMID: 33542619 PMCID: PMC7853408 DOI: 10.2147/opth.s287087] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 12/14/2020] [Indexed: 12/22/2022] Open
Abstract
Objective This study aimed to evaluate the epidemiological and clinicopathological spectrum of ocular malignancies among patients presenting to a teaching hospital in Northern India. Methods A total of 246 histopathologically diagnosed patients with ocular malignancies were included in the study. Tumor type and size, primary origin and location of tumor, clinical staging, radiological findings, histopathological type, and treatment outcomes were assessed. Results Overall, males over 55 years of age were most commonly affected and the majority of cases were primary ocular or adnexal malignancies (n = 226; 91.87%). The eyelids and periocular structures (n = 92; 37.40%) were the most commonly involved site, followed by the orbit (n = 72; 29.27%), ocular surface (n = 46; 18.70%) and intraocular region (n = 36; 14.63%). The majority of the patients (n = 68; 27.64%) were managed by primary surgical excision and reconstruction. However, 46 patients (18.70%) with advanced lesions underwent neoadjuvant chemotherapy followed by surgical excision and more extensive orbital lesions were treated by exenteration followed by adjuvant chemotherapy (n=48; 19.51%), while patients with metastatic tumor were given palliative chemotherapy/external beam radiation therapy (n= 46; 18.70%). Overall, 45.12% of patients were cured completely, 15.45% showed a partial response to the treatment, 13.04% had progressive disease and 16.67% demonstrated disease recurrence. Conclusion A clinicopathological analysis of ocular malignancies at a teaching hospital in Northern India indicated the preponderance of primary ocular malignancies, with eyelid sebaceous gland carcinomas being the most common pathological diagnosis. Most of our patients had advanced and extensive disease among them majority belonged to the rural background and poor socio-economic status.
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Affiliation(s)
- Abdullah Al-Mujaini
- Department of Ophthalmology, College of Medicine and Health Sciences, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
| | - Rajendra Prakash Maurya
- Regional Institute of Ophthalmology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India
| | - Sanjay Bosak
- Regional Institute of Ophthalmology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India
| | - Manish Kumar Karan
- Regional Institute of Ophthalmology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India
| | - Meghna Roy
- Regional Institute of Ophthalmology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India
| | - Virendra Pratap Singh
- Regional Institute of Ophthalmology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India
| | - Mahendra Kumar Singh
- Regional Institute of Ophthalmology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India
| | - Ajay Kumar
- Department of Zoology, Institute of Science, Banaras Hindu University, Varanasi 221005, India
| | - Samer Singh
- Centre for Experimental Medicine & Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India
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Melder K, Zwagerman N, Gardner PA, Wang EW. Endoscopic Endonasal Approach for Intra- and Extraconal Orbital Pathologies. J Neurol Surg B Skull Base 2020; 81:442-449. [PMID: 33072484 DOI: 10.1055/s-0040-1713940] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Endoscopic endonasal approaches offer an important alternative in the management of posterior inferomedial orbital pathology. Beginning with endoscopic orbital decompressions for Graves' disease, the endonasal corridor for the management of intra- and extraconal pathologies has continued to evolve. Endonasal removal of orbital cavernous hemangiomas is well described in the literature; however, many other benign and malignant pathologies of the medial orbit can be accessed through this approach. Advantages of the endonasal approach include improved visualization and decreased manipulation of orbital contents in the medial and posterior orbit. Additionally, for tumors that extend from the paranasal sinuses into the orbit, this corridor may be ideal for concurrent management. The current literature for this approach will be reviewed including the oncologic results, complications, limitations, and reconstructive needs along with pertinent anatomy. In addition, data from our own institution will be reviewed.
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Affiliation(s)
- Katie Melder
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Nathan Zwagerman
- Department of Neurological Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Paul A Gardner
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Eric W Wang
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
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10
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Wang EW, Zanation AM, Gardner PA, Schwartz TH, Eloy JA, Adappa ND, Bettag M, Bleier BS, Cappabianca P, Carrau RL, Casiano RR, Cavallo LM, Ebert CS, El-Sayed IH, Evans JJ, Fernandez-Miranda JC, Folbe AJ, Froelich S, Gentili F, Harvey RJ, Hwang PH, Jane JA, Kelly DF, Kennedy D, Knosp E, Lal D, Lee JYK, Liu JK, Lund VJ, Palmer JN, Prevedello DM, Schlosser RJ, Sindwani R, Solares CA, Tabaee A, Teo C, Thirumala PD, Thorp BD, de Arnaldo Silva Vellutini E, Witterick I, Woodworth BA, Wormald PJ, Snyderman CH. ICAR: endoscopic skull-base surgery. Int Forum Allergy Rhinol 2020; 9:S145-S365. [PMID: 31329374 DOI: 10.1002/alr.22326] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 02/12/2019] [Accepted: 02/15/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Endoscopic skull-base surgery (ESBS) is employed in the management of diverse skull-base pathologies. Paralleling the increased utilization of ESBS, the literature in this field has expanded rapidly. However, the rarity of these diseases, the inherent challenges of surgical studies, and the continued learning curve in ESBS have resulted in significant variability in the quality of the literature. To consolidate and critically appraise the available literature, experts in skull-base surgery have produced the International Consensus Statement on Endoscopic Skull-Base Surgery (ICAR:ESBS). METHODS Using previously described methodology, topics spanning the breadth of ESBS were identified and assigned a literature review, evidence-based review or evidence-based review with recommendations format. Subsequently, each topic was written and then reviewed by skull-base surgeons in both neurosurgery and otolaryngology. Following this iterative review process, the ICAR:ESBS document was synthesized and reviewed by all authors for consensus. RESULTS The ICAR:ESBS document addresses the role of ESBS in primary cerebrospinal fluid (CSF) rhinorrhea, intradural tumors, benign skull-base and orbital pathology, sinonasal malignancies, and clival lesions. Additionally, specific challenges in ESBS including endoscopic reconstruction and complication management were evaluated. CONCLUSION A critical review of the literature in ESBS demonstrates at least the equivalency of ESBS with alternative approaches in pathologies such as CSF rhinorrhea and pituitary adenoma as well as improved reconstructive techniques in reducing CSF leaks. Evidence-based recommendations are limited in other pathologies and these significant knowledge gaps call upon the skull-base community to embrace these opportunities and collaboratively address these shortcomings.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Adam J Folbe
- Michigan Sinus and Skull Base Institute, Royal Oak, MI
| | | | | | - Richard J Harvey
- University of Toronto, Toronto, Canada.,University of New South Wales, Sydney, Australia
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Charles Teo
- Prince of Wales Hospital, Randwick, Australia
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11
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Lang SJ, Joachimsen L, Stifter J, Reich M, Küchlin S, Böhringer D, Metzger M, Lagrèze WA. [Use of the Multidisciplinary Specialised Case Conference at the Freiburg Orbital Centre]. Klin Monbl Augenheilkd 2020; 237:985-989. [PMID: 32016941 DOI: 10.1055/a-1078-1412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND The treatment of tumors increasingly takes place in specialised interdisciplinary centres. Therapeutic decisions are usually made at case conferences. Ophthalmologists, oromaximillofacial surgeons, ENT physicians, neurosurgeons, as well as pediatricians, radiotherapists and radiologists are all involved in the treatment of orbital diseases. The aim of this article is to present the concept of a multidisciplinary case conference for orbital diseases and to analyse case numbers, indications, and the influence on the patient's therapy. METHODS We analysed an anonymized data set of patients who presented in the case conference of the University Hospital Freiburg from 2008 to 2018 with regard to clinical diagnosis, histological diagnoses, number of surgical interventions, and number of interdisciplinary therapy decisions. RESULTS From 2008 to 2018, 545 patients were presented in a weekly conference. Of these, 453 were available for anonymous evaluation. The median age was 56 years (quartiles 41; 69). The most frequent indication was an orbital tumour of unclear malignancy (n = 52; 11%). Further indications included Grave's orbitopathy (n = 39; 9%), orbital pseudotumour (n = 36; 8%), cranial nerve palsy (n = 22; 5%), and orbital lymphoma (n = 22; 5%). The most frequent histological diagnoses were B-cell lymphoma (n = 10; 2%), venous malformation (cavernoma, n = 8; 2%), marginal zone lymphoma (n = 8; 2%), and squamous cell carcinoma (n = 6; 1%). An interdisciplinary therapeutic approach was defined for 174 patients. CONCLUSION A high demand for the interdisciplinary case conference was demonstrated. The high rate of primary or secondary interdisciplinary decisions indicates the value of such a conference. Hence, the patient is spared multiple examinations in the individual specialist areas and quick and effective therapy decisions can be achieved.
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Affiliation(s)
- Stefan J Lang
- Klinik für Augenheilkunde, Albert-Ludwigs-Universität Freiburg, Freiburg im Breisgau
| | - Lutz Joachimsen
- Klinik für Augenheilkunde, Albert-Ludwigs-Universität Freiburg, Freiburg im Breisgau
| | - Julia Stifter
- Klinik für Augenheilkunde, Albert-Ludwigs-Universität Freiburg, Freiburg im Breisgau
| | - Michael Reich
- Klinik für Augenheilkunde, Albert-Ludwigs-Universität Freiburg, Freiburg im Breisgau
| | - Sebastian Küchlin
- Klinik für Augenheilkunde, Albert-Ludwigs-Universität Freiburg, Freiburg im Breisgau
| | - Daniel Böhringer
- Klinik für Augenheilkunde, Albert-Ludwigs-Universität Freiburg, Freiburg im Breisgau
| | - Marc Metzger
- Klinik für Mund-, Kiefer- und Gesichtschirurgie, Albert-Ludwigs-Universität Freiburg, Freiburg im Breisgau
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12
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Abstract
Many abnormalities of the orbit present with neuro-ophthalmic findings, such as impaired ocular motility or alignment, and sensory changes, including optic neuropathy. Comprehensive coverage of all orbital diseases is beyond the scope of this article. This review focuses on diagnosis and management of the most common and the most vision- or life-threatening orbital conditions as well as more recently discovered entities and points of active controversy. These conditions include orbital trauma, vascular disease, inflammatory and infectious diseases, and neoplasms. Common presenting symptoms and associated neuro-orbital diseases also are summarized.
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Affiliation(s)
- Jessica R Chang
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Anna M Gruener
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Timothy J McCulley
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
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13
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Khan AA, Sarwar S, Sadiq MAA, Ahmad I, Tariq N, Sibghat-Ul-Noor. Analysis of orbital malignancies presenting in a tertiary care hospital in Pakistan. Pak J Med Sci 2017; 33:70-74. [PMID: 28367175 PMCID: PMC5368332 DOI: 10.12669/pjms.331.12073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective: To determine the frequencies of various orbital malignancies amongst orbital lesions in patients presenting in a tertiary care hospital in Pakistan. Methods: A retrospective analysis of 666 orbital cases with an established histopathological diagnosis of malignant tumors treated in Mayo Hospital Lahore from 1996 to 2015 (20 years). Results: About 66% of the malignant tumors were primary, 25% secondary, 8% haematopoietic and 1% metastatic. Almost 50% of the cases were children. Retinoblastoma is the commonest tumor (43% overall and 87% among children). Squamous cell carcinoma is the second commonest (15.6% overall and 31% among adults). These are then followed by Adenoid cystic carcinoma of Lacrimal Gland (9%), Lymphoma/Leukaemia (8%) and Rhabdomyosarcoma (6.3%). Conclusion: Frequencies of various orbital malignancies show geographical variation in both paediatric and adult population.
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Affiliation(s)
- Asad Aslam Khan
- Prof. Dr. Asad Aslam Khan, MS (Ophth), PhD (Ophth). Institute of Ophthalmology/College of Ophthalmology and Allied Vision Sciences, King Edward Medical University, Mayo Hospital, Lahore, Pakistan
| | - Suhail Sarwar
- Dr. Suhail Sarwar, MS Ophthalmology. Institute of Ophthalmology/College of Ophthalmology and Allied Vision Sciences, King Edward Medical University, Mayo Hospital, Lahore, Pakistan
| | - Mohammad Ali A Sadiq
- Dr. Mohammad Ali A Sadiq, FCPS Ophthalmology, FPOS (UK), FAAPOS (USA). Institute of Ophthalmology/College of Ophthalmology and Allied Vision Sciences, King Edward Medical University, Mayo Hospital, Lahore, Pakistan
| | - Imran Ahmad
- Dr. Imran Ahmad, DOMS, MPH. Institute of Ophthalmology/College of Ophthalmology and Allied Vision Sciences, King Edward Medical University, Mayo Hospital, Lahore, Pakistan
| | - Nayab Tariq
- Dr. Nayab Tariq, MBBS. Institute of Ophthalmology/College of Ophthalmology and Allied Vision Sciences, King Edward Medical University, Mayo Hospital, Lahore, Pakistan
| | - Sibghat-Ul-Noor
- Dr. Sibghat-ul-Noor, MBBS. Institute of Ophthalmology/College of Ophthalmology and Allied Vision Sciences, King Edward Medical University, Mayo Hospital, Lahore, Pakistan
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14
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Hassan WM, Bakry MS, Hassan HM, Alfaar AS. Incidence of orbital, conjunctival and lacrimal gland malignant tumors in USA from Surveillance, Epidemiology and End Results, 1973-2009. Int J Ophthalmol 2016; 9:1808-1813. [PMID: 28003984 DOI: 10.18240/ijo.2016.12.18] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 06/22/2016] [Indexed: 12/24/2022] Open
Abstract
AIM To determine the types and incidence of tumors affecting the orbit, conjunctiva and lacrimal glands and to study the trend line of these tumors in the United States from 1973 to 2009. METHODS We used the publicly available Surveillance, Epidemiology and End Results (SEER) database registries to determine the incidence rates. Age was adjusted to the 2000 US Standard Population. Patients were stratified according to age group, gender, race and histological grouping of tumor lesions. Three age groups were defined: 0-19, 20-49 and ≥50y. Annual percentage changes were calculated to examine trends. RESULTS The overall age adjusted incidence rate was 3.39 (95%CI: 3.27-3.52) per million person-years. The tumors were more prevalent in age group ≥50 counting 9.51 (95%CI: 9.11-9.92) per million person-years. Most of the soft tissue sarcomas occurred in the young age with incidence rate of 0.35 (95%CI: 0.28-0.42) per million person-years. Lymphomas were the dominant subtype in the adult population with incidence rate of 5.74 (95%CI: 5.43-6.06) per million person-years. Incidence rates were higher in males than females with an overall rate ratio of 1.31 (95%CI: 1.21-1.41) mainly caused by the increase in carcinoma subtypes. White race had a higher tumor incidence with a rate ratio of 1.47(95%CI: 1.25-1.73) driven by the higher incidence of most histological subtypes. Orbital tumors showed a higher incidence rate followed by conjunctival and lacrimal gland tumors with incidence rates of 1.59, 1.37 and 0.43 per million person-years respectively. The trend line of overall incidence of tumors showed a significant increase (APC=3.11, 95%CI: 2.61-3.61) mainly due to increase of lymphomas. This increase was higher than the increase of lymphomas at other sites. CONCLUSION Orbital, conjunctival and lacrimal gland malignant tumors differ among children and adults. Over the years there has been a noticeable increase in incidence rates of orbital and lacrimal gland tumors mainly caused by an increase in lymphomas and an apparent increase due to advances in diagnostic techniques. ICD-O-3 topographical coding should be improved to consider the different orbital bones and ocular structures.
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Affiliation(s)
- Waleed M Hassan
- Research Department, Children Cancer Hospital Egypt 57357, Cairo 11441, Egypt
| | - Mohamed S Bakry
- Research Department, Children Cancer Hospital Egypt 57357, Cairo 11441, Egypt
| | | | - Ahmad S Alfaar
- Research Department, Children Cancer Hospital Egypt 57357, Cairo 11441, Egypt; Ophthalmology Department, Charité-Universtätsmedizin Berlin, Berlin 10117, Germany
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15
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Koch KR, Matthaei M, Grau SJ, Blau T, Bölke E, Schlichting O, Cursiefen C, Heindl LM. Benign orbital angiomatous tumors with intracranial extension. Eur J Med Res 2015; 20:63. [PMID: 26260738 PMCID: PMC4531435 DOI: 10.1186/s40001-015-0157-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 07/31/2015] [Indexed: 11/12/2022] Open
Abstract
Orbital neoplasms with associated bone erosions and intracranial extension are generally considered suspicious for malignancies. Here, we describe the clinical and radiological findings, as well as the surgical management of two extraordinary cases, in which such bony perforations with subsequent intracranial tumor growth resulted from benign angiomatous orbital neoplasms. Two female patients, 69 years old (case 1) and 51 years old (case 2), had both developed visual symptoms (visual field restrictions and/or visual acuity loss) over several months. Computed tomography revealed an orbital tumor of the anterosuperior orbit with painless swelling of the medial upper eyelid of the right eye in case 1, and a posterior intraconal tumor close to the orbital apex of the left eye in case 2, respectively. In both cases, the tumor was associated with a perforation of the orbital roof connecting the orbit with the anterior cranial fossa. An interdisciplinary ophthalmologic and neurosurgical approach allowed for complete tumor removal, in both patients with no signs for local recurrence during the subsequent follow-up of 15 and 18 months, respectively, as well as for a satisfactory visual rehabilitation.
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Affiliation(s)
- Konrad R Koch
- Department of Ophthalmology, University of Cologne, Cologne, Germany.
| | - Mario Matthaei
- Department of Ophthalmology, University of Cologne, Cologne, Germany.
| | - Stefan J Grau
- Department of Neurosurgery, University of Cologne, Cologne, Germany.
| | - Tobias Blau
- Department of Neuropathology, University of Cologne, Cologne, Germany.
| | - Edwin Bölke
- Department of Radiology and Radiooncology, University of Duesseldorf, Duesseldorf, Germany. .,Department of Radiation Oncology, University of Duesseldorf, Duesseldorf, Germany.
| | - Ole Schlichting
- Department of Ophthalmology, University of Cologne, Cologne, Germany.
| | - Claus Cursiefen
- Department of Ophthalmology, University of Cologne, Cologne, Germany.
| | - Ludwig M Heindl
- Department of Ophthalmology, University of Cologne, Cologne, Germany.
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Jurdy L, Merks JHM, Pieters BR, Mourits MP, Kloos RJHM, Strackee SD, Saeed P. Orbital rhabdomyosarcomas: A review. Saudi J Ophthalmol 2013; 27:167-75. [PMID: 24227982 DOI: 10.1016/j.sjopt.2013.06.004] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Rhabdomyosarcoma (RMS) is a highly malignant tumor and is one of the few life-threatening diseases that present first to the ophthalmologist. It is the most common soft-tissue sarcoma of the head and neck in childhood with 10% of all cases occurring in the orbit. RMS has been reported from birth to the seventh decade, with the majority of cases presenting in early childhood. Survival has changed drastically over the years, from 30% in the 1960's to 90% presently, with the advent of new diagnostic and therapeutic modalities. The purpose of this review is to provide a general overview of primary orbital RMS derived from a literature search of material published over the last 10 years, as well as to present two representative cases of patients that have been managed at our institute.
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Affiliation(s)
- Lama Jurdy
- Orbital Centre, Department of Ophthalmology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
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An analysis of 2,480 space-occupying lesions of the orbit from 1976 to 2011. Ophthalmic Plast Reconstr Surg 2013; 29:79-86. [PMID: 23470516 DOI: 10.1097/iop.0b013e31827a7622] [Citation(s) in RCA: 147] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE To evaluate the frequencies of orbital space-occupying lesions seen at single orbital unit in a period of 35 years. METHODS In this retrospective case series, the authors reviewed the medical records of 2,480 consecutive patients referred to the authors' Orbital Unit for evaluation of an orbital mass between 1976 and 2011. The final diagnosis in each case was established by a combination of history, ocular findings, diagnostic imaging, and histopathologic analysis, when available. The number and percentage of benign and malignant tumors were determinated, also according to the age of the patients and the tumor location within the orbit. This study adhered to the principles of the Declaration of Helsinki. RESULTS Of the 2,480 lesions, 1,697 (68%) were benign and 783 (32%) were malignant. The most frequent benign tumors were dermoid cyst (14%) and cavernous hemangioma (9%). The most common malignant tumors were non-Hodgkin lymphoma (12%), basal cell carcinoma (3%), and orbital metastases (3%). In patients younger than 60 years, benign tumors are more frequent, whereas in patients older than 60 years, the frequency of malignant tumors increased. Regarding the distribution in the orbit, the most common tumors were dermoid cyst (206 cases) in the upper-outer quadrant, mucocele (155 cases) in the upper-inner quadrant, basal cell epithelioma (35 cases) in the lower-inner quadrant, cavernous hemangioma (68 cases) in the lower-outer quadrant, and meningioma (90 cases) in central space. Most of the tumors were located in the upper-outer quadrant. In the lower-inner quadrant, malignant tumors were more frequent than benign tumors. CONCLUSIONS The authors' findings highlight the distinctive nature of the orbital oncology experience at an ocular oncology department.
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Sugnanam K, Ooi L, Mollee P, Vu P. Gamma-delta T-cell lymphoma with CNS involvement presenting with proptosis: a case study workup, treatment and prognosis. Orbit 2012; 31:364-366. [PMID: 23030408 DOI: 10.3109/01676830.2012.711411] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Ocular adnexal lymphomas are rare and T cell variants are a minor subset of these lymphomas. We aim to describe a case report which underlines the diagnostic and treatment challenge of this rare pathology. CASE A 34-year-old gentleman has been shown to have exophthalmos and dysfunction of cranial nerve V andVII unilaterally. Imaging including CT and MRI brain and orbits do not show a CNS component to the disease. It was later identified as an ocular adnexal lymphoma with a central nervous system (CNS) component diagnosed via lumbar puncture. DISCUSSION We highlight the importance of excluding ocular adnexal lymphoma and difficulty of management of the disease where it presents as a masquerade syndrome for orbital cellulitis.
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Affiliation(s)
- Kirthi Sugnanam
- Princess Alexandra Hospital, Ophthalmology, Annerley, Queensland, Argentina.
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