A Novel Approach to the Differentiation of Intrabulbar Tumors in Color Doppler Imaging

Gigantic Ocular Squamous Cell Carcinoma Mixed With Fibrosarcoma in a Mare: Clinical, Laboratory, Ultrasonography and Histopathology Findings

Ocular neoplasms represent 10% of all equine neoplasms and ocular squamous cell carcinoma (OSCC) is the most common one. This report describes the clinical presentation, laboratory, ultrasonography, postmortem, histopathology and immunohistochemistry findings of a mixed ocular neoplasm in a 10-year-old draft mare. The mare had a one-year history of left ocular mass. Complete destruction of the left eye with loss of vision was observed. A large ulcerated mass oozing blood replaced the left eye. Left parotid lymph node was swollen and had a sinus tract discharging pus. Ultrasonography revealed absence of all intraocular structures, several lobular echogenic tissues and several hyperechoic areas of ossification with acoustic shadowing. Color Doppler scanning revealed numerous neovascularization all over the tumor, particularly along the periphery. The neovascularization demonstrated mainly arterial with few mixed blood flow signals. The amplitude of systolic and diastolic blood flow was markedly increased. Enucleation was decided but the mare died just after examination. The ocular mass was excised and its weight was 390 g. Postmortem examination revealed no distant metastasis in all internal organs. Histopathology confirmed OSCC mixed with fibrosarcoma and associated with cartilaginous and osseous metaplasia. The neoplastic cells gave positive nuclear p53 immunoreactivity. The left parotid lymph node revealed metastasis. Despite the unsuccessful outcome in this particular case, this report documents a mixed eye neoplasm, highlights the ultrasonography and histopathology features of OSCC, and reinforces the need for early diagnosis and surgical treatment in such cases to improve the outcome and to decrease the drastic complications and mortality.

Guidelines for ultrasound examination in ophthalmology. Part III: Color Doppler ultrasonography

The aim of this article was to present the possibilities of use and application of color-coded Doppler ultrasonography in the diagnosis of various diseases of the eyeball and orbit which result from vascular disorders. Color-coded Doppler ultrasonography is recommended for the assessment of blood flow velocity in the retrobulbar arteries. That is why the article contains current recommendations for Doppler imaging in ophthalmology. The paper provides detailed recommendations for patient's preparation for the examination, presents the scanning technique and safety of the examination, and lists ophthalmological diseases of vascular origin for which color-coded Doppler ultrasonography can be applied. Furthermore, the article also presents other techniques applied in clinical practice for the assessment of blood flow or imaging of vasculature of a given eyeball structure, inter alia: power Doppler ultrasonography, 3D and 4D ultrasonography, magnetic resonance angiography, spiral computer tomography, transcranial ultrasonography and modern microvascular imaging. The authors emphasize the usefulness of color-coded Doppler ultrasonography in the diagnosis of diseases which result from blood flow disorders within the eyeball, such as amaurosis fugax, ocular ischemic syndrome, insufficiency in vessels supplying the carotid and vertebral arteries, posterior ischemic optic neuropathy, glaucoma, age-related macular degeneration, vascular vision disorders, vascular malformations, such as arteriovenous fistula, orbital varices, systemic connective tissue diseases in retinopathy of prematurity, diabetes, thyroid disorders or strabismus. The application of color-coded Doppler ultrasonography is especially important in the assessment of the vasculature of intrabulbar tumorous lesions and in the differential diagnosis of intrabulbar tumors.

The aim of this article was to present the possibilities of use and application of color-coded Doppler ultrasonography in the diagnosis of various diseases of the eyeball and orbit which result from vascular disorders. Color-coded Doppler ultrasonography is recommended for the assessment of blood flow velocity in the retrobulbar arteries. That is why the article contains current recommendations for Doppler imaging in ophthalmology. The paper provides detailed recommendations for patient’s preparation for the examination, presents the scanning technique and safety of the examination, and lists ophthalmological diseases of vascular origin for which color-coded Doppler ultrasonography can be applied. Furthermore, the article also presents other techniques applied in clinical practice for the assessment of blood flow or imaging of vasculature of a given eyeball structure, inter alia: power Doppler ultrasonography, 3D and 4D ultrasonography, magnetic resonance angiography, spiral computer tomography, transcranial ultrasonography and modern microvascular imaging. The authors emphasize the usefulness of color-coded Doppler ultrasonography in the diagnosis of diseases which result from blood flow disorders within the eyeball, such as amaurosis fugax, ocular ischemic syndrome, insufficiency in vessels supplying the carotid and vertebral arteries, posterior ischemic optic neuropathy, glaucoma, age-related macular degeneration, vascular vision disorders, vascular malformations, such as arteriovenous fistula, orbital varices, systemic connective tissue diseases in retinopathy of prematurity, diabetes, thyroid disorders or strabismus. The application of color-coded Doppler ultrasonography is especially important in the assessment of the vasculature of intrabulbar tumorous lesions and in the differential diagnosis of intrabulbar tumors.