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Finisanti R, Perkasa MF, Prawira AM, Faruk M. Orbital hemangioma extirpation via a transnasal endoscopic surgical approach: A case report. Int J Surg Case Rep 2023; 103:107898. [PMID: 36640470 PMCID: PMC9846022 DOI: 10.1016/j.ijscr.2023.107898] [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: 09/26/2022] [Revised: 12/26/2022] [Accepted: 01/10/2023] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Orbital tumors are heterogeneous lesions originating from various structures in the eyeball, including the extraconal, conal, and intraconal spaces. One orbital tumor type is a vascular tumor, such as a hemangioma. Hemangiomas are most common in women aged 20-64 years. They are painless and slow-growing, leading to proptosis. The diagnosis can generally be established by clinical examination and computed tomography (CT) or magnetic resonance imaging scans. Orbital hemangioma management can involve regular observation of small and asymptomatic tumors or surgery for large symptomatic tumors. PRESENTATION OF CASE We report a 20-year-old Asian woman who presented with swelling on the medial side of her right eyelid that had increased over the last three months. A non-contrast head CT scan showed a mass in the right eye's medial wall. The patient underwent a joint operation with an ophthalmologist to remove the median orbital tumor by transnasal endoscopic orbital surgery. Anatomical pathology examination of the tumor tissue identified hemangiomas. CONCLUSION An endoscopic transnasal approach is a safe and effective way to access and manage an orbital tumor medial to the optic nerve. It is essential to have a multidisciplinary team with experience in endoscopic procedures. This patient had satisfactory results at their three-month postoperative follow-up. They reported no symptoms, and their CT scan did not show a relapsed mass in the right oculi region.
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Affiliation(s)
- Ratih Finisanti
- Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
| | - Muhammad Fadjar Perkasa
- Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
| | - Adi Matra Prawira
- Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
| | - Muhammad Faruk
- Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
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Nichat V, Shenouda N, Koujak K, Zwicker K, Barrowman N, Bijelic V, Shapira-Zaltsberg G. Clinical and Radiological Correlation of Low Flow Vascular Malformation Treated With Percutaneous Sclerotherapy. Can Assoc Radiol J 2022; 74:415-421. [PMID: 36167492 DOI: 10.1177/08465371221128696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: To retrospectively correlate imaging findings post-sclerotherapy of low-flow vascular malformations with clinical outcome. Materials and Methods: We retrospectively evaluated 81 pediatric patients who had sclerotherapy in our department over a 14-year period. Patients with a diagnosis of low-flow vascular malformation, pre and post-treatment ultrasound (US) and clinical follow-up evaluation were included in the study. Exclusion criteria were coexisting high-flow vascular malformations, history of additional surgical or medical treatment to their malformation and large infiltrative lesions difficult to measure on US. Pre and post-treatment sonographic volumes of the malformation were assessed. Changes in volume were categorized into 6- increased volume, stable and volume decrease of 1-25%/26-50%/51-75%/75-100%. Clinical outcomes were categorized into 4 - worse, no change, improved and symptom free. In cases where pre-treatment MRI was available, the estimated malformation volumes in both modalities were correlated using Spearman's rank correlation. The change in sonographic volume was correlated with clinical outcome using Spearman's rank correlation. P-values < .05 were considered significant. Results: Twenty-nine patients were included in the study; 13 with venous malformation (VM), and 16 with lymphatic malformation (LM). Nineteen patients had both pre-treatment US and MRI, showing correlation in volume between the 2 modalities (P < .001). Post-treatment change in volume correlated with clinical outcome for combined venous and LMs (rho = .44, P = .02). No correlation was found when venous (rho = .48, P = .09) and lymphatic (rho = .33, P = .21) malformations were considered separately. Conclusion: Ultrasound can potentially be used as an objective tool in evaluating sclerotherapy treatment response of low-flow vascular malformations in the pediatric population.
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Affiliation(s)
- Vaibhav Nichat
- Department of Medical Imaging, 27338CHEO, Ottawa, ON, Canada.,University of Ottawa, ON, Canada
| | - Nazih Shenouda
- Department of Medical Imaging, 27338CHEO, Ottawa, ON, Canada.,University of Ottawa, ON, Canada
| | - Khaldoun Koujak
- Department of Medical Imaging, 27338CHEO, Ottawa, ON, Canada.,University of Ottawa, ON, Canada
| | - Kelley Zwicker
- University of Ottawa, ON, Canada.,Department of Pediatrics, 27338CHEO, Ottawa, ON, Canada
| | | | - Vid Bijelic
- Research Institute, 27338CHEO, Ottawa, ON, Canada
| | - Gali Shapira-Zaltsberg
- Department of Medical Imaging, 27338CHEO, Ottawa, ON, Canada.,University of Ottawa, ON, Canada
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