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Spina A, Boari N, Calvanese F, Gagliardi F, Bailo M, Piloni M, Mortini P. Brain Tumors Affecting the Orbit Globe and Orbit Tumors Affecting the Brain. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1405:507-526. [PMID: 37452951 DOI: 10.1007/978-3-031-23705-8_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Brain tumors affecting the orbit and orbital tumors affecting the brain are a heterogeneous group of lesions, with histological features, behaviors, diagnostic criteria, and treatments varying from each other. Dermoid cyst and cavernous hemangiomas are considered the most frequent benign lesions, while non-Hodgkin lymphoma is the most common malignant tumor in this region. Sharing the same anatomical region, clinical manifestations of orbital lesions may be often common to different types of lesions. Imaging studies are useful in the differential diagnosis of orbital lesions and the planning of their management. Lesions can be classified into ocular or extra-ocular ones: the latter can be further differentiated into extraconal or intraconal, based on the relationship with the extraocular muscles. Surgical therapy is the treatment of choice for most orbital lesions; however, based on the degree of removal, their histology and extension, other treatments, such as chemotherapy and radiotherapy, are indicated for the management of orbital lesions. In selected cases, chemotherapy and radiotherapy are the primary treatments. This chapter aimed to discuss the orbital anatomy, the clinical manifestations, the clinical testing and the imaging studies for orbital lesions, and the principal pathological entities affecting the orbit together with the principles of orbital surgery.
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Affiliation(s)
- Alfio Spina
- Department of Neurosurgery and Gamma Knife Radiosurgery, Vita-Salute San Raffaele University and IRCCS San Raffaele Scientific Institute, Milan, Italy.
| | - Nicola Boari
- Department of Neurosurgery and Gamma Knife Radiosurgery, Vita-Salute San Raffaele University and IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesco Calvanese
- Department of Neurosurgery and Gamma Knife Radiosurgery, Vita-Salute San Raffaele University and IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Filippo Gagliardi
- Department of Neurosurgery and Gamma Knife Radiosurgery, Vita-Salute San Raffaele University and IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Michele Bailo
- Department of Neurosurgery and Gamma Knife Radiosurgery, Vita-Salute San Raffaele University and IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Martina Piloni
- Department of Neurosurgery and Gamma Knife Radiosurgery, Vita-Salute San Raffaele University and IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Pietro Mortini
- Department of Neurosurgery and Gamma Knife Radiosurgery, Vita-Salute San Raffaele University and IRCCS San Raffaele Scientific Institute, Milan, Italy
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Hadrawi M, Alghamdi A, Alageel N, Abudawood G, Alshareef F, Abuauf M. Early vascular embolization of large orbital and periorbital infantile capillary hemangiomas; A case report. Am J Ophthalmol Case Rep 2022; 25:101377. [PMID: 35198806 PMCID: PMC8851098 DOI: 10.1016/j.ajoc.2022.101377] [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: 12/28/2021] [Accepted: 01/28/2022] [Indexed: 12/02/2022] Open
Abstract
Purpose Infantile hemangiomas (IH) are the most common benign vascular tumors in childhood. Although they tend to have a benign nature, some hemangiomas may be complicated with astigmatism or deprivation amblyopia. We report a unique case of using an interventional radiological vascular embolization treatment modality for the early management of amblyogenic large right orbital and periorbital infantile capillary hemangiomas. Observations After the confirmation of the diagnosis using a magnetic resonance imaging (MRI) of the brain and orbit, and an initial trial of systemic propranolol, an early interventional radiological vascular embolization was done. This was combined with the use of a tapering systemic corticosteroid. The functional and cosmetic outcomes were satisfactory. Conclusions and Importance The use of arterial embolization is a promising modality of treatment as a possible alternative or adjunct to medical and surgical treatment cases of IH. To the authors’ knowledge, this is one of the rare cases reported in the ophthalmic literature addressing the use of this technique for early management of orbital and periorbital capillary hemangiomas.
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Affiliation(s)
- Manal Hadrawi
- Department of Ophthalmology, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Amer Alghamdi
- Department of Family Medicine, Ministry of National Guard - Health Affairs, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Nourah Alageel
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Ghufran Abudawood
- Department of Ophthalmology, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Fawaz Alshareef
- Department of Radiology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Mawahib Abuauf
- Department of Pediatrics, Neonatal Division, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
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Zahavi A, Luckman J, Ben-David GS, Toledano H, Michowiz S, Vardizer Y, Goldenberg-Cohen N. Proptosis due to intraorbital space-occupying lesions in children. Graefes Arch Clin Exp Ophthalmol 2020; 258:2541-2550. [PMID: 32676791 DOI: 10.1007/s00417-020-04840-3] [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: 02/03/2020] [Revised: 07/05/2020] [Accepted: 07/10/2020] [Indexed: 10/23/2022] Open
Abstract
PURPOSE To report the 10-year experience of two tertiary medical centers with children presenting with proptosis due to an intraorbital space-occupying lesion. METHODS Patients were identified by file review. Data were collected on demographics, findings on ophthalmologic and imaging evaluations, etiology, treatment, and outcome. RESULTS Nineteen children (7 male) were included. Eleven patients had optic nerve glioma, including 9 with substantially decreased visual acuity. Treatment consisted of chemotherapy alone or with radiation, resection or anti-VEGF agents, MEK inhibitor, or observation only (n = 1). Visual and cosmetic outcomes were poor in all cases. Outcome for arteriovenous malformations was good following corticosteroid treatment (n = 1), but catheterization led to persistent proptosis and fluctuating visual acuity (n = 1). Compound capillary hemangioma (n = 1) was treated with laser and systemic beta blockers with satisfactory results. Rhabdomyosarcoma had a good prognosis in one patient treated with resection and radiation but was fatal in another even after chemotherapy. Juvenile xanthogranuloma, frontal bone osteoma, and localized hypertrophic neuropathy of the supraorbital nerve (n = 1 each) were treated by resection with good visual and cosmetic outcomes. CONCLUSIONS Proptosis accompanied by visual loss is an uncommon presentation in children and suggests an orbital tumor. We found that visual outcome was better when the nerve was not involved by tumor. Optic nerve glioma was the most common cause and failed to respond to various treatments. Catheterization for arteriovenous malformation did not prevent proptosis, and final visual acuity fluctuated. Surgery for rhabdomyosarcoma and xanthogranuloma led to remission with preservation of vision in 2 of 3 cases.
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Affiliation(s)
- Alon Zahavi
- Sackler Faculty of Medicine, Tel Aviv University, 6997801, Tel Aviv, Israel.,Department of Ophthalmology, Rabin Medical Center, Beilinson Hospital, 4941492, Petah Tikva, Israel.,Krieger Eye Research Laboratory, Felsenstein Medical Research Center, 4941492, Petah Tikva, Israel
| | - Judith Luckman
- Department of Radiology, Rabin Medical Center, Beilinson Hospital, 4941492, Petah Tikva, Israel
| | - Geulah S Ben-David
- Sackler Faculty of Medicine, Tel Aviv University, 6997801, Tel Aviv, Israel
| | - Helen Toledano
- Sackler Faculty of Medicine, Tel Aviv University, 6997801, Tel Aviv, Israel.,Department of Oncology, Schneider Children's Medical Center of Israel, 49420235, Petah Tikva, Israel
| | - Shalom Michowiz
- Department of Neurosurgery, Hadassah Medical Center, 91120, Jerusalem, Israel
| | - Yoav Vardizer
- Department of Ophthalmology, Bnai-Zion Medical Center, 3339419, Haifa, Israel
| | - Nitza Goldenberg-Cohen
- Krieger Eye Research Laboratory, Felsenstein Medical Research Center, 4941492, Petah Tikva, Israel. .,Department of Ophthalmology, Bnai-Zion Medical Center, 3339419, Haifa, Israel. .,Technion - Israel Institute of Technology, 3200003, Haifa, Israel.
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Trapeznikova TV, Pisklakova TP, Khomchenko VV, Kalashnikova NG, Lotti T, Jafferany M. New technology for coagulation of dilated vessels using the combined effects of several modes of generation and wavelengths in one laser pulse for the treatment of pediatric hemangiomas: Open prospective study. Dermatol Ther 2020; 33:e13341. [PMID: 32222107 DOI: 10.1111/dth.13341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 03/25/2020] [Indexed: 11/29/2022]
Abstract
An open, prospective, nonrandomized study of 122 children with infantile hemangiomas aged 1 to 24 months was conducted to evaluate the effectiveness and safety of treatment with multiline laser equipment using the Nd:YAP Q-Sw/KTP emitters with the combined use of two wavelengths of 1079/540 nm. The average age of the children was (6.3 ± 0.3) months, 22 of them were boys (18.0%) and 100 were girls (82.0%). An erythometry and ultrasound examination were performed to determine the depth of the neoplasm, to assess its blood flow, and the presence and diameter of the supply vessels. Studies of these indicators were conducted for patients before and after the treatment. Laser treatment was performed on 109 patients with 119 hemangiomas. A total of 81 superficial hemangiomas underwent a short course of laser therapy (2-5 procedures) and remaining patients with 38 combined hemangiomas received a long course of laser treatment, consisting of 6 to 10 procedures. Restoration of normal color, skin relief, and the absence of scars were noted in post-treatment sample on evaluation. After the course of treatment, erythometry readings corresponded to the values of normal skin and decreased to 110 to 80 cu. Ultrasound examination showed vascular formation and feed vessels were not visualized.
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Affiliation(s)
- Tatyana V Trapeznikova
- Department of Dermatology, FSBOU VPO "Southern Ural State Medical University", Chelyabinsk, Russia
| | - Tatyana P Pisklakova
- Institute of Sport, Tourism and Service, South Ural State University, Chelyabinsk, Russia
| | - Vladimir V Khomchenko
- Institute of Sport, Tourism and Service, South Ural State University, Chelyabinsk, Russia
| | | | - Torello Lotti
- Department of Dermatology, University G. Marconi of Rome, Dermatology and Venereology, Rome, Italy
| | - Mohammad Jafferany
- College of Medicine, Central Michigan University, Saginaw, Michigan, USA
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