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Siktberg JC, Kovach AE, Borinstein SC, Correa H, Virgin FW, Sobel RK. Persistent mass after treatment for orbital rhabdomyosarcoma. Am J Ophthalmol Case Rep 2022; 25:101274. [PMID: 35106404 PMCID: PMC8789529 DOI: 10.1016/j.ajoc.2022.101274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 10/30/2021] [Accepted: 01/13/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Jonathan C. Siktberg
- Vanderbilt University School of Medicine, 1161 21st Ave S # D3300, Nashville, TN, USA, 37232
| | - Alexandra E. Kovach
- Division of Pediatric Pathology, Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN, USA, 37232
| | - Scott C. Borinstein
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Vanderbilt University Medical Center, 2220 Pierce Ave, Nashville, TN, USA, 37232
| | - Hernan Correa
- Division of Pediatric Pathology, Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN, USA, 37232
| | - Frank W. Virgin
- Department of Otolaryngology, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN, USA, 37232
| | - Rachel K. Sobel
- Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, 2311 Pierce Ave, Nashville, TN, USA, 37232
- Corresponding author. Vanderbilt Eye Institute, 2311 Pierce Ave, Nashville, TN, 37232, USA.
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Wei R, Li M, Yang W, Xu H, Choi J, Zhou X. Case Report: Phototherapeutic Keratectomy for Band Keratopathy Secondary to Chemo-Laser-Cryotherapy for Retinoblastoma. Front Med (Lausanne) 2021; 8:668762. [PMID: 34513859 PMCID: PMC8423897 DOI: 10.3389/fmed.2021.668762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 08/04/2021] [Indexed: 12/03/2022] Open
Abstract
Purpose: To report the clinical outcomes of phototherapeutic keratectomy (PTK) for pediatric band keratopathy after treatment for retinoblastoma. Methods: A 5-year-old boy presented with a 2-year history of poor visual acuity and a horizontal gray-white band across the central cornea in the right eye. He was diagnosed with band keratopathy after chemo-laser-cryotherapy for retinoblastoma. The band keratopathy was treated via PTK using the Mel-90 excimer laser with an optical treatment zone of 7.0 mm and ablation depth of 120 μm. The patient was followed at 1 week and 3 months postoperatively. Results: Surgery and postoperative follow-up were uneventful. At the 3-month follow-up, the uncorrected distant visual acuity of the right eye improved to 20/125, and the corrected distance visual acuity improved to 20/70 with a refraction of +10.00 D/−2.50 DC × 15. The clarity of the ablated area was evidently improved. The central corneal thickness decreases from 612 to 584 μm. The optical coherence tomography showed the thin band of hyperreflectivity in the ablated area disappeared, corneal transparency improved and the corneal surface smoothened. Conclusions: PTK is a safe and effective procedure to treat band keratopathy following treatment of retinoblastoma in children. Early intervention can reduce the risk of developing deprivation amblyopia.
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Affiliation(s)
- Ruoyan Wei
- Department of Ophthalmology and Optometry, Eye and ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Meiyan Li
- Department of Ophthalmology and Optometry, Eye and ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Weiming Yang
- Department of Ophthalmology, Children's Hospital of Fudan University, Shanghai, China
| | - Haipeng Xu
- Department of Ophthalmology and Optometry, Eye and ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Joanne Choi
- Kresge Eye Institute/Department of Ophthalmology, Wayne State University, Detroit, MI, United States
| | - Xingtao Zhou
- Department of Ophthalmology and Optometry, Eye and ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
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Nasal Embryonal Rhabdomyosarcoma in the Pediatric Population: Literature Review and Report of Midline Presentation. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3534. [PMID: 33889472 PMCID: PMC8057758 DOI: 10.1097/gox.0000000000003534] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 02/22/2021] [Indexed: 11/30/2022]
Abstract
Background: Congenital midline nasal masses are rare anomalies and are typically benign nasal dermoid sinus cysts (NDSCs). Rhabdomyosarcomas (RMSs) are even less common, and only a fraction affect sites like the external nose, nasal cavity, nasopharynx, and paranasal sinuses. We review the clinical presentation and treatment of nasal, nasopharyngeal, and paranasal RMSs and report the first documented midline presentation. Methods: We queried PubMed for articles with titles containing the terms rhabdomyosarcoma or sarcoma botryoides and nose, nasal, paranasal, sinonasal, nasopharynx, or nasopharyngeal. We then searched the references of each included article using the same parameters and continued this process iteratively until no new articles were found. Results: The paranasal sinuses were the most commonly affected site, followed by the nasopharynx, nasal cavity, and external nose. Two patients presented with involvement of the external nose, but each presented with involvement of the right ala rather than a midline mass. The rates of intracranial extension and/or skull base involvement were comparable to those of NDSCs. The alveolar subtype was most common, followed by the embryonal subtype. Conclusions: Most midline nasal masses are benign; however, we report the first documented presentation of an RMS as a midline nasal mass. Accordingly, RMS should be included in the differential diagnosis of midline nasal masses in the pediatric population. Surgery for midline nasal masses is sometimes delayed due to the risks of interfering with developing structures and early anesthesia. However, early surgical treatment should be considered given this new differential and its predilection for early metastasis.
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Thaung C. Orbital pathology - Iatrogenic findings and artefacts. Saudi J Ophthalmol 2018; 32:17-22. [PMID: 29755266 PMCID: PMC5944018 DOI: 10.1016/j.sjopt.2018.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Revised: 02/01/2018] [Accepted: 02/08/2018] [Indexed: 12/01/2022] Open
Abstract
The relationship between the ophthalmologist and ophthalmic pathologist is particularly important in orbital disease, as diagnosis is heavily dependent on correlation with clinical context. If the patient has previously had treatment to the orbit or an adjacent area, whether for the same or a different condition, tissue changes may occur which affect the histological appearance of any specimen taken. This article is an overview of therapeutic interventions which may cause either orbital pathology or an altered appearance of the tissue, either of which can pose a diagnostic challenge. The problem of artefact is also addressed as another factor which may alter the appearance of a specimen. It is hoped that the information provided in this brief review will help clinicians better evaluate what information may be relevant when submitting a specimen.
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Li A, Blandford A, Chundury RV, Traboulsi EI, Anderson P, Murphy E, Parikh S, Perry J. Orbital rhabdomyosarcoma in a child with Leigh syndrome. J AAPOS 2018; 22:150-152.e1. [PMID: 29274371 DOI: 10.1016/j.jaapos.2017.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Revised: 07/24/2017] [Accepted: 09/11/2017] [Indexed: 11/18/2022]
Abstract
We present the case of a 6-year old girl with Leigh syndrome and an orbital rhabdomyosarcoma and describe her clinical course and our multidisciplinary approach to treatment. To our knowledge, this is the first report of rhabdomyosarcoma in a patient with Leigh syndrome.
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Affiliation(s)
- Ang Li
- Department of Ophthalmology, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio.
| | - Alexander Blandford
- Department of Ophthalmology, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
| | - Rao V Chundury
- Department of Ophthalmology, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
| | - Elias I Traboulsi
- Department of Ophthalmology, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
| | - Peter Anderson
- Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic, Cleveland, Ohio
| | - Erin Murphy
- Radiation Oncology, Cleveland Clinic, Cleveland, Ohio
| | - Sumit Parikh
- Center for Pediatric Neurosciences, Cleveland Clinic, Cleveland, Ohio
| | - Julian Perry
- Department of Ophthalmology, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
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Eade E, Tumuluri K, Do H, Rowe N, Smith J. Visual outcomes and late complications in paediatric orbital rhabdomyosarcoma. Clin Exp Ophthalmol 2016; 45:168-173. [DOI: 10.1111/ceo.12809] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 07/20/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Edwina Eade
- Department of Ophthalmology; Children's Hospital Westmead; Sydney New South Wales Australia
| | - Krishna Tumuluri
- Department of Ophthalmology; Children's Hospital Westmead; Sydney New South Wales Australia
| | - Helen Do
- Department of Ophthalmology; Children's Hospital Westmead; Sydney New South Wales Australia
| | - Neil Rowe
- Department of Ophthalmology; Children's Hospital Westmead; Sydney New South Wales Australia
| | - James Smith
- Department of Ophthalmology; Children's Hospital Westmead; Sydney New South Wales Australia
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Farnia B, Majumder MA, Paulino AC. Ethical analysis as a tool for addressing treatment controversies: radiotherapy timing in children with orbital rhabdomyosarcoma as a case example. J Am Coll Radiol 2014; 12:484-90. [PMID: 25544244 DOI: 10.1016/j.jacr.2014.10.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 10/16/2014] [Accepted: 10/20/2014] [Indexed: 11/26/2022]
Abstract
PURPOSE The treatment of orbital rhabdomyosarcoma is a topic of debate between North American and European clinicians, with the utility of radiation therapy as part of initial management in question. Despite differences in philosophy, the dominant North American approach of upfront radiation and the dominant European approach of radiation only in the event of recurrence yield a similar rate of overall survival. We sought to identify the ethical arguments for each approach. METHODS Established moral principles and appeals in contemporary medical ethics were utilized to identify the ethical arguments supporting each treatment approach. The potential for technologic advances to alter the analysis was considered. RESULTS Emphasizing the principle of beneficence, the North American approach seeks to reduce recurrence rates. In contrast, the European approach seeks to avoid radiation-induced sequelae, emphasizing the principle of nonmaleficence. Both approaches are based on well-established ethical principles, evidence, and clinical experience. Thus, both approaches currently appear to have legitimacy and should be included in the informed consent process. However, if treatment-related toxicity is reduced through improvements in radiation delivery, the North American approach could emerge as ethically superior. CONCLUSIONS Ethical analysis can aid in addressing challenges that arise when professional practices and perspectives differ in the management of cancer patients.
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Affiliation(s)
- Benjamin Farnia
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mary A Majumder
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas
| | - Arnold C Paulino
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Pediatrics, Baylor College of Medicine, Houston, Texas.
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Elomrani F, Touri S, Ouziane I, Berrada N, Boutayeb S, Mrabti H, Elkhannoussi B, Errihani H. Orbital rhabdomyosarcoma with skin metastasis: a case report. BMC Res Notes 2014; 7:670. [PMID: 25253623 PMCID: PMC4181003 DOI: 10.1186/1756-0500-7-670] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2013] [Accepted: 09/23/2014] [Indexed: 11/26/2022] Open
Abstract
Background Rhabdomyosarcoma is a soft tissue neoplasm that usually arises in the headand neck region and genitourinary tract. Skin metastasis of rhabdomyosarcoma is extremely rare; of thirteen cases reported in the literature, most were children younger than 10 years and only three cases have been reported in adults. Case presentation A 20-year-old Moroccan man was admitted with a right orbital tumor. The tumor was excised and histopathology examination confirmed a diagnosis of rhabdomyosarcoma. The patient was treated with chemotherapy, but local recurrence occurred one year later. The patient underwent right orbital exenteration followed by chemotherapy and radiotherapy. After 6 months, the patient developed a cutaneous mass in the right lumbar region, which was resected. Immunohistochemical examination of the tumor showed this to be a cutaneous metastasis of rhabdomyosarcoma. The patient was treated by chemotherapy and there appeared to be no recurrence after 9 months of follow up. Conclusions Skin metastasis from rhabdomyosarcoma is extremely rare, particularly in adults. The purpose of presenting this case report is to raise awareness among clinicians— skin biopsy and immunohistochemistry are needed to distinguish this neoplasm from other cutaneous tumors so that appropriate treatment can be initiated.
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Affiliation(s)
- Fadwa Elomrani
- Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco.
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