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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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Torrado-Cobian LA, Griepentrog GJ, Hodge DO, Mohney BG. Prevalence and clinical features of orbital vascular anomalies in children. Orbit 2023; 42:598-602. [PMID: 36644978 PMCID: PMC10691662 DOI: 10.1080/01676830.2023.2166081] [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: 10/11/2022] [Accepted: 01/03/2023] [Indexed: 01/17/2023]
Abstract
PURPOSE To report the prevalence, clinical characteristics, and natural history of orbital vascular anomalies diagnosed among children over a 50-year period. METHODS The medical records of all patients <19 years diagnosed with any form of an orbital vascular anomaly (OVA) at Mayo Clinic, Rochester, Minnesota from January 1 1966, through December 31 2015, were retrospectively reviewed. RESULTS A total of 109 children were diagnosed with OVA during the 50-year period, of which 24 were from Olmsted County, MN, yielding a birth prevalence of 1 in 4,305 live births. The median age at diagnosis for the 109 patients was 1.2 years (range, 0-17.9 years) and 67 (61.5%) were female. Common presenting symptoms included proptosis in 80 (73.4%) patients, abnormalities in skin color in 45 (41.3%) patients, and pain in 18 (16.5%) patients. There were 55 (50.5%) vascular malformations [50 (91%) low-flow lymphatic malformations, 3 (5.5%) high-flow arteriovenous malformations, and 2 (3.5%) low-flow venous malformations] and 54 (49.5%) vascular tumors [53 (98%) capillary hemangiomas and 1 (2%) kaposiform hemangioendothelioma]. During a mean follow-up of 5.95 years (range 0-27.7 years), amblyopia and/or strabismus were diagnosed in 46 (43.4%) patients. CONCLUSIONS Capillary hemangiomas and low-flow lymphatic malformations comprise most of the orbital vascular anomalies in this cohort of children. Amblyopia and strabismus are common sequelae, highlighting the importance of early diagnosis and appropriate management.
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Affiliation(s)
- Laura A. Torrado-Cobian
- Mayo Clinic Department of Ophthalmology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota
| | - Gregory J. Griepentrog
- Department of Ophthalmology & Visual Sciences at the Medical College of Wisconsin, Mayo Clinic and Mayo Foundation, Rochester, Minnesota
| | - David O. Hodge
- Mayo Clinic Division of Biostatistics, Mayo Clinic and Mayo Foundation, Rochester, Minnesota
| | - Brian G. Mohney
- Mayo Clinic Department of Ophthalmology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota
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Saad AL-Zomia A, AL-Zehefa IA, Alqarni AM, Al Muidh AM, Mesfer Almousa A, Faez Al-Qaed A, Alshahrani AS, Mohammed Asiri B, Asiri GB, Ali Lahiq L, Al-Amri MA, Al-Nujimi MS, Alfaisal SM, Tawhari I. A Retrospective Study of Ocular Cancer in Saudi Arabia: 25-Year Analysis. Clin Ophthalmol 2023; 17:3103-3111. [PMID: 37877115 PMCID: PMC10591673 DOI: 10.2147/opth.s433118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 10/10/2023] [Indexed: 10/26/2023] Open
Abstract
Background Ocular malignancies are uncommon among eye diseases; however, they jeopardize both vision and life. The main objective of this study was to use to describe the epidemiology of eye and ocular adnexa malignancies across different ages and sex. Methods The King Khaled University institutional review board approved this study. Data on ocular cancer were retrieved from the Saudi Cancer Registry between 1994 and 2018. The registry collected important patient information such as demographic information (age, gender, and nationality), clinical details, and tumor classification. Results The total number of cases with ocular cancer diagnosed was 1051 cases. The highest number was recorded in Riyadh (35.39%, n=372), followed by Makkah (16.93%, n=178). The incidence was higher in the 0-4 years' age group (55.21%), and it got down as people got older. The data also revealed differences in the number of reported cases over time, as well as in the representation of eye cancer cases by gender and nationality. While many ocular cancer pathologies were seen, with "Retinoblastoma, not otherwise specified" being the most common (53.32%), the incidence rates for males and females remained largely stable over time. Conclusion The study emphasizes the need for continued monitoring, research, and analysis of potential of epidemiology of ocular cancer occurrence in Saudi Arabia. Identifying the geographical distribution and age pattern of Ocular malignancies have the potential to assist healthcare authorities and policymakers in developing precise strategies to reduce, recognize at an early stage, and successfully manage this condition.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Lama Ali Lahiq
- Faculty of Medicine, King Khalid University, Abha, Saudi Arabia
| | | | | | | | - Ibrahim Tawhari
- Faculty of Medicine, King Khalid University, Abha, Saudi Arabia
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Lyvannak S, Khauv P, Keller FG, Leventaki V, Camitta B. Pyrites: Proptosis. J Pediatr Hematol Oncol 2022; 44:347-350. [PMID: 35797179 DOI: 10.1097/mph.0000000000002491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/16/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Sam Lyvannak
- Angkor Hospital for Children, Siem Reap, Cambodia
| | - Phara Khauv
- Angkor Hospital for Children, Siem Reap, Cambodia
| | - Frank G Keller
- Children's Healthcare of Atlanta/Emory University, Atlanta, GA
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Alkatan HM, Al Marek F, Elkhamary S. Demographics of Pediatric Orbital Lesions: A Tertiary Eye Center Experience in Saudi Arabia. J Epidemiol Glob Health 2020; 9:3-10. [PMID: 30932383 PMCID: PMC7310758 DOI: 10.2991/jegh.k.181224.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Accepted: 11/07/2017] [Indexed: 12/23/2022] Open
Abstract
Orbital lesions vary in their classification, incidence, and presentation depending on the age and geographic distribution. Such lesions in the pediatric age group have been studied extensively because of the possibility of faster progression of orbital involvement and the higher risk of morbidity in this age group in which vision is still developing. In Saudi Arabia, orbital lesions were studied over a 6-year period in the late 1980s, when retinoblastoma cases used to present late with orbital involvement. In this study, we revisited the same topic 20 years later aiming to find out the most recent prevalence of orbital lesions in a similar population of patients over a longer period (14 years) in the same eye center, and compare the current results to other reports worldwide. A total of 107 lesions from 106 patients were identified by tissue diagnosis, of which more than half of the lesions were benign cystic (being the most common), vasculogenic, and inflammatory in 63% [95% confidence interval (CI, 53.3-72.0)] of all biopsied lesions. Neoplasms accounted for 37% [95% CI (28.0-45.8)] with rhabdomyosarcoma being the most common, accounting for about one third of neoplasms, and no orbital cases of retinoblastoma were found. Our results demonstrated different distribution of orbital lesions in recent years reflecting the indirect effect of the improved health awareness and medical care in Saudi Arabia. This baseline demographic study is expected to be helpful for further clinical and prognostic studies with emphasis on pediatric orbital malignant lesions, their clinical presentation, management, and prognosis.
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Affiliation(s)
- Hind Manaa Alkatan
- Department of Ophthalmology, College of Medicine, King Saud University, PO Box 18097, Riyadh, Postal code 11415, Saudi Arabia.,Department of Pathology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Department of Pathology and Laboratory Medicine, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Faisal Al Marek
- Department of Ophthalmology, Al-Imam Muhammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Sahar Elkhamary
- Department of Diagnostic Radiology, Mansoura Faculty Of Medicine, Egypt
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A Rare Pediatric Case of Lacrimal Gland Pleomorphic Adenoma. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 7:e2435. [PMID: 31942397 PMCID: PMC6908400 DOI: 10.1097/gox.0000000000002435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 07/12/2019] [Indexed: 11/26/2022]
Abstract
Pleomorphic adenoma of the lacrimal gland is a rare benign finding in adults, and extremely uncommon in children. These tumors often present with increased propotosis or hypoglobus, and they invariably require operative excision. While many of these lesions can be removed through a subcranial or transorbital exposure, larger and more posterior tumors occasionally necessitate an intracranial approach. This report describes a large lacrimal gland pleomorphic adenoma in a 16 year-old patient that required use of an expansive intracranial exposure to ensure complete excision including the capsule. We contrast this case and its management to other pediatric cases described in the literature.
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Amir SP, Kamaruddin MI, Akib MNR, Sirajuddin J. Orbital cellulitis clinically mimicking rhabdomyosarcoma. Int Med Case Rep J 2019; 12:285-289. [PMID: 31692563 PMCID: PMC6716584 DOI: 10.2147/imcrj.s201678] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 07/08/2019] [Indexed: 12/13/2022] Open
Abstract
Introduction Proptosis in children with acute-onset accompanied by signs of inflammation is commonly caused by orbital cellulitis, however, the possibility of rhabdomyosarcoma should always be considered by the clinician. This is a case report of a five-year-old boy presenting with an acute-onset of proptosis without a history of trauma and systemic infection. Our clinical differential diagnosis included orbital cellulitis and orbital rhabdomyosarcoma. Purpose To report a case of orbital cellulitis that clinically and radiologically mimics rhabdomyosarcoma. Case presentation A five-year-old boy presented with rapid-onset proptosis, periorbital edema, pain and visual loss in the left eye for two weeks without a history of trauma, upper respiratory tract infection, sinusitis or immunosuppression. Our clinical differential diagnosis includes rhabdomyosarcoma and orbital cellulitis. Complete blood count reveals a leukocytosis. Multislice computed tomography (MSCT) scan shows lesions involving the lateral orbit and the retro bulbar space. Antibiotics combination and adjunct anti-inflammatory intravenously shows excellent clinical resolution. Conclusions The study demonstrates difficulty in differentiating acute orbital cellulitis from rhabdomyosarcoma based on clinical findings. In addition, the case highlights that antibiotic combination of cephalosporin and aminoglycosides together with an adjuvant corticosteroid as an anti-inflammatory was effective in the case of acute orbital cellulitis.
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Affiliation(s)
- Suliati P Amir
- Department of Ophthalmology, Hasanuddin University, Makassar, South Sulawesi, Indonesia.,Department of Ophthalmology, Muslim University of Indonesia, Makassar, South Sulawesi, Indonesia
| | | | - Marliyanti Nur Rahmah Akib
- Department of Ophthalmology, Hasanuddin University, Makassar, South Sulawesi, Indonesia.,Department of Ophthalmology, Muslim University of Indonesia, Makassar, South Sulawesi, Indonesia
| | - Junaedi Sirajuddin
- Department of Ophthalmology, Hasanuddin University, Makassar, South Sulawesi, Indonesia
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Yeşiltaş YS, Gündüz K, Okçu Heper A, Erden E. Ectopic rhabdoid meningioma of the orbit in a child: case report and review of the literature. J Neurosurg Pediatr 2018; 22:151-157. [PMID: 29726794 DOI: 10.3171/2018.1.peds17557] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In August 2016, an 11-year-old boy presented to the authors' institution with a right orbital tumor that was located superotemporally (superolaterally) and adherent to the sclera. The patient's past medical history revealed that he had undergone 2 previous craniotomies elsewhere in June 2008 and July 2010 for a superomedially located orbital lesion that had been histopathologically diagnosed as a neurothekeoma. After the second craniotomy, the patient underwent adjuvant intensity modulated radiotherapy (IMRT) to the right medial orbit. At the authors' institution, total excision of the orbital tumor was performed via an anterior conjunctival orbitotomy. Histopathological examination revealed a rhabdoid meningioma. Review of the histopathology obtained at the time of previous tumor excisions showed that the lesion was misdiagnosed as neurothekeoma and instead represented a meningioma from the beginning. The patient was started on a regimen of oral sunitinib and remained free of recurrence at 1.5 years of follow-up. Ectopic meningioma of the orbit is a rare entity. Rhabdoid meningioma is a rarely seen subtype of meningioma, accounting for 1%-3% of all intracranial meningiomas. To the best of the authors' knowledge, this is the first case of an ectopic orbital rhabdoid meningioma reported in the literature. They suspect that tumor seeding during the previous surgeries might have played a role in the occurrence of the tumor in an orbital location not targeted by IMRT.
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Affiliation(s)
| | | | - Aylin Okçu Heper
- 2Pathology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Esra Erden
- 2Pathology, Ankara University Faculty of Medicine, Ankara, Turkey
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Domingo RED, Manganip LE, Castro RM. Tumors of the eye and ocular adnexa at the Philippine Eye Research Institute: a 10-year review. Clin Ophthalmol 2015; 9:1239-47. [PMID: 26185414 PMCID: PMC4501349 DOI: 10.2147/opth.s87308] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE We aimed to identify and describe the clinicopathologic characteristics of tumors of the eye and ocular adnexa at the Philippine Eye Research Institute. METHODS The pathology reports of specimens submitted to the Ocular Pathology Section of the Philippine Eye Research Institute over a 10-year period (2003-2012) were reviewed, and collected data was subjected to descriptive statistical tabulation and analysis. RESULTS A total of 1,551 histologically confirmed tumors were included. Of these, 254 were from the conjunctiva (155 benign, 99 malignant), 530 from the eyelids (360 benign, 170 malignant), 394 were intraocular tumors (21 benign, 373 malignant), and 373 were from the orbit (231 benign, 142 malignant). Retinoblastoma was the most common tumor of the eye and ocular adnexa in the series, accounting for 43.2% of all malignancies. Squamous cell carcinoma was the most frequent cancer of the conjunctiva, while basal cell carcinoma and sebaceous gland carcinoma were the most common eyelid malignancies. Orbital malignancies had a bimodal age distribution, with rhabdomyosarcoma being most frequent in children, while in adults, lymphoma was most common, followed by lacrimal gland carcinomas. CONCLUSION The majority of tumors of the conjunctiva, eyelids, and orbit were benign, while most intraocular tumors were malignant, with retinoblastoma being the most common.
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Affiliation(s)
- Rolando Enrique D Domingo
- Philippine Eye Research Institute, National Institutes of Health, University of the Philippines, Manila, Philippines ; Department of Ophthalmology and Visual Sciences, University of the Philippines College of Medicine - Philippine General Hospital, Manila, Philippines
| | - Lilibeth E Manganip
- Philippine Eye Research Institute, National Institutes of Health, University of the Philippines, Manila, Philippines
| | - Rolando M Castro
- Philippine Eye Research Institute, National Institutes of Health, University of the Philippines, Manila, Philippines
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Singh D, Pushker N, Bajaj MS, Saxena R, Sharma S, Ghose S. Visual function alterations in orbital tumors and factors predicting visual outcome after surgery. Eye (Lond) 2011; 26:448-53. [PMID: 22157916 DOI: 10.1038/eye.2011.308] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To study the effect of orbital tumors on visual functions and highlight the factors predictive of visual outcome after surgery. METHODS A prospective interventional study compared visual function parameters and fundus changes, before and after surgery, in eyes having well-defined orbital tumors with the normal fellow eye. These included visual acuity (VA), refractive error, keratometry changes, color vision, Goldmann visual field (GVF), and visual evoked response (VER). RESULTS In total 28 cases (age range 7-56 years), of which the majority of tumors were vascular (46%) and lacrimal (18%) in origin, had a mean VA of 0.54±0.33 in the affected eye, which improved postoperatively to 0.66±0.31 (P=0.002). The affected eye had a median refractive error of +0.00 DS (-2.00 to 5.13), which was significantly more hyperopic than the normal eye (median +0.00 DS; range -1.25 to +1.63 DS) and normalized postoperatively. Keratometry showed higher astigmatism in the involved eye (P=0.004). The fundus showed disc pallor, edema, and/or choroidal folds, of which disc edema resolved in all cases after surgery. In all, 40% of the affected eyes had a deficient color vision and this partially improved postoperatively (P=0.25). GVF had abnormalities in 10 cases, half of which normalized postoperatively (P=0.04). The VER of affected eyes had a mean amplitude of 8.91±4.59 μv and latency of 116.3±14.7 ms, with improvement after surgery (P=0.005 and 0.001, respectively). CONCLUSION Orbital tumors adversely affected visual functions. The presenting acuity depended on disc changes, color vision abnormalities, and prolonged VER latency. The postoperative VA depended on VA at presentation, amount of proptosis, degree of hyperopia, and clinically significant VER abnormalities.
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Affiliation(s)
- D Singh
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Das JK, Tiwary BK, Paul SB, Bhattacharjee H, Cida B, Das D. Primary orbital rhabdomyosarcoma with skeletal muscle metastasis. Oman J Ophthalmol 2011; 3:91-3. [PMID: 21217904 PMCID: PMC3003859 DOI: 10.4103/0974-620x.64235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We report a case of embryonal orbital rhabdomyosarcoma (RMS) in a five year old boy. Immuno-histochemistry of incisional specimen confirmed diagnosis. Eight cycles of chemotherapy along with radiotherapy resulted in over 50% reduction in size of the mass. However, increase in size was noted subsequent to completion of therapy and exenteration was deemed prudent. Margins of the excised specimen were free from tumor cells, but after five months, the patient developed multiple metastases, including skeletal muscle involvement, and died nine months after exenteration, despite repeat chemotherapy along with radiotherapy. Orbital RMS with metastasis to skeletal muscle is a rare entity.
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Affiliation(s)
- Jayanta K Das
- Department of Ophthalmology, Sri Sankaradeva Nethralaya, Guwahati, India
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[Orbital tumours in children and adolescents. Differential diagnostics and clinical symptoms]. Ophthalmologe 2010; 107:543-8. [PMID: 20393733 DOI: 10.1007/s00347-009-2068-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The aim of this retrospective study was to determine the incidence of and surgical strategies used for treating orbital tumours in children and adolescents. PATIENTS AND METHODS A retrospective chart review was carried out for 22 patients between the ages of 2 weeks and 18 years who were treated in the years 1997-2007 for suspected space-occupying orbital lesions. The specific investigation methods, therapy, and treatment results were described. RESULTS The most frequent orbital lesions in the children in this study were mesenchymal tumours; the second most common were dermoids. Nineteen patients were surgically treated. Three children with malignant tumours underwent radiochemotherapy after surgery, and two died in the first year after diagnosis. Two other children with benign tumours suffered recurrence of their disease. CONCLUSION The variety of orbital diseases in paediatric patients includes benign and malignant tumours as well as nonneoplastic lesions. The treatment of orbital disease is a diagnostic and therapeutic challenge for the attending physician.
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Liu GT, Volpe NJ, Galetta SL. Orbital disease in neuro-ophthalmology. Neuroophthalmology 2010. [DOI: 10.1016/b978-1-4160-2311-1.00018-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Extraconal orbital tumors in children--a spectrum. Virchows Arch 2009; 454:703-13. [PMID: 19421774 DOI: 10.1007/s00428-009-0775-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2009] [Revised: 03/22/2009] [Accepted: 04/13/2009] [Indexed: 12/30/2022]
Abstract
Orbital masses in children are uncommon but extremely challenging problems for clinicians and pathologists due to their critical location and availability of limited diagnostic material. We analyzed 47 specimens comprising biopsies, excision specimens, and FNAC of extraconal pediatric orbital masses (excluding retinoblastoma) accessioned in the pathology department over 5 years in a tertiary referral cancer center. Immunohistochemistry (IHC-74%) and molecular methods (one case) were done where necessary. The chief presenting symptom was proptosis in 55.3% patients and radiologically 53.8% malignant tumors showed extraorbital extension. A diagnostic algorithm was formulated to assess which cases needed pathology evaluation. Malignant round cell tumors (76.6%), chiefly embryonal rhabdomyosarcoma (51%), benign spindle cell neoplasms, and infectious lesions (tuberculosis, fungal infections), were seen. Of the malignant tumors, those confined to the orbit achieved good treatment response and had an event-free follow-up while those with extraorbital spread had poor outcome. Pediatric orbital masses range from completely treatable infectious lesions, surgically resectable benign neoplasms to aggressive malignancies requiring chemotherapy and radiotherapy. Pathologists play a key role in distinguishing these on small biopsy material and expediating accurate treatment thus saving the vision or life of a patient.
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Bibliography. Current world literature. Pediatrics and strabismus. Curr Opin Ophthalmol 2007; 18:434-6. [PMID: 17700239 DOI: 10.1097/icu.0b013e3282f0361d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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