1
|
Akyildiz A, Ismayilov R, Rustamova N, Tokatli M, Koc I, Akin S, Kiratli H, Barista I. Comprehensive analysis of orbital lymphoma in a Turkish cohort: clinical characteristics, histological subtypes, treatment modalities, prognostic factors, and implications for management. Ann Hematol 2024; 103:905-915. [PMID: 38057424 DOI: 10.1007/s00277-023-05569-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/27/2023] [Indexed: 12/08/2023]
Abstract
The study analysed the clinical characteristics, treatment approaches, and survival outcomes of 97 consecutive patients with orbital lymphoma (OL) over a 25-year period at. The median age of the patients was 57.6 years, and 59.8% (n = 58) were male. Marginal zone lymphoma constitutes the most prevalent subtype, accounting for 67% of cases, whereas other common subtypes include diffuse large B-cell lymphoma, follicular lymphoma, mantle cell lymphoma, Burkitt lymphoma, and T-cell lymphomas. Unilateral involvement was observed in the majority of cases (72.3%). Common clinical presentations included mass (30.9%), swelling (26.8%), and epiphora (11.3%). Of the patients, 7.2% received rituximab alone, 14.4% received radiotherapy alone, 48.5% received chemotherapy, 27.8% received radiotherapy plus rituximab, 22.7% received radiotherapy plus chemotherapy, and 5.2% underwent surgery as the first-line treatment. During a median follow-up of 4.3 years, 15.5% of patients experienced relapse or disease progression. The 5-year and 10-year progression-free survival rates were 84.1% and 79.1%, respectively. This study contributes to our understanding of OLs and provides a foundation for further investigations in this field. Male gender, presence of B symptoms, advanced stage, secondary orbital lymphoma, aggressive histological subtype, and elevated serum lactate dehydrogenase levels were associated with poorer (either inferior or worse) progression-free survival.
Collapse
Affiliation(s)
- Arif Akyildiz
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Rashad Ismayilov
- Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey.
| | - Nargiz Rustamova
- Department of Ophthalmology, Hacettepe University Medical School, Ankara, Turkey
| | - Mert Tokatli
- Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Irem Koc
- Department of Ophthalmology, Hacettepe University Medical School, Ankara, Turkey
| | - Serkan Akin
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Hayyam Kiratli
- Department of Ophthalmology, Hacettepe University Medical School, Ankara, Turkey
| | - Ibrahim Barista
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| |
Collapse
|
2
|
Elbaze S, Duron L, Mambour N, Zmuda M, Krystal S, Guillaume J, Savatovsky J, Lecler A. A signature of structural MRI features at 3 Tesla allows an accurate characterization of orbital cavernous venous malformation. Eur Radiol 2023; 33:2149-2159. [PMID: 36264311 DOI: 10.1007/s00330-022-09163-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 07/26/2022] [Accepted: 09/07/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To differentiate OCVM from other orbital lesions using structural MRI. METHODS This IRB-approved a historical-prospective cohort single-center analysis of a prospective cohort that included consecutive adult patients presenting with an orbital lesion undergoing a 3T MRI before surgery from December 2015 to May 2021. Two readers blinded to all data read all MRIs assessing structural MRI characteristics. A univariate analysis followed by a stepwise multivariate analysis identified structural MRI features showing the highest sensitivity and specificity when diagnosing OCVM. RESULTS One hundred ninety-one patients with 30/191 (16%) OCVM and 161/191 (84%) other orbital lesions were included. OCVM were significantly more likely to present with a higher signal intensity than that of the cortex on T2WI: 26/29 (89.7%) versus 28/160 (17.5%), p < 0.001, or with a chemical shift artifact (CSA): 26/29 (89.7%) versus 16/155 (10.3%), p < 0.001, or to present with a single starting point of enhancement, as compared to other orbital lesions: 18/29 (62.1%) versus 4/159 (2.5%), p = 0.001. The step-wise analysis identified 2 signatures increasing performances. Signature 1 combined a higher signal intensity than that of the cortex on T2WI and a CSA. Signature 2 included these two features and the presence of a single starting point of enhancement. Sensitivity, specificity, and accuracy were 0.83, 0.94, and 0.92 for signature 1 and 0.97, 0.93, and 0.93 for signature 2, respectively. CONCLUSION Structural MRI yields high sensitivity and specificity when diagnosing OCVM. KEY POINTS • Structural MRI shows high sensitivity and specificity when diagnosing orbital cavernous venous malformation. • We identified two signatures combining structural MRI features which might be used easily in routine clinical practice. • The combination of higher signal intensity of the lesion as compared to the cortex on T2WI and of a chemical shift artifact yields a sensitivity and specificity of 0.83 and 0.94 for the diagnosis of orbital cavernous venous malformation, respectively.
Collapse
Affiliation(s)
- Simon Elbaze
- Department of Neuroradiology, Foundation Adolphe de Rothschild Hospital, 25 rue Manin, 75019, Paris, France.
| | - Loïc Duron
- Department of Neuroradiology, Foundation Adolphe de Rothschild Hospital, 25 rue Manin, 75019, Paris, France
| | - Natasha Mambour
- Department of Orbital and Palpebral Surgery, Foundation Adolphe de Rothschild Hospital, Paris, France
| | - Mathieu Zmuda
- Department of Orbital and Palpebral Surgery, Foundation Adolphe de Rothschild Hospital, Paris, France
| | - Sidney Krystal
- Department of Neuroradiology, Foundation Adolphe de Rothschild Hospital, 25 rue Manin, 75019, Paris, France
| | - Jessica Guillaume
- Department of Clinical Research, Foundation Adolphe de Rothschild Hospital, Paris, France
| | - Julien Savatovsky
- Department of Neuroradiology, Foundation Adolphe de Rothschild Hospital, 25 rue Manin, 75019, Paris, France
| | - Augustin Lecler
- Department of Neuroradiology, Foundation Adolphe de Rothschild Hospital, 25 rue Manin, 75019, Paris, France
| |
Collapse
|
3
|
Lecler A, Duron L, Charlson E, Kolseth C, Kossler AL, Wintermark M, Moulin K, Rutt B. Comparison between 7 Tesla and 3 Tesla MRI for characterizing orbital lesions. Diagn Interv Imaging 2022; 103:433-439. [PMID: 35410799 DOI: 10.1016/j.diii.2022.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/23/2022] [Accepted: 03/24/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE Characterizing orbital lesions remains challenging with imaging. The purpose of this study was to compare 3 Tesla (T) to 7 T magnetic resonance imaging (MRI) for characterizing orbital lesions. MATERIALS AND METHODS This prospective single-center study enrolled participants presenting with orbital lesions from May to October 2019, who underwent both 7 T and 3 T MRI examinations. Two neuroradiologists, blinded to all data, read both datasets independently and randomly. They assessed general characteristics of each orbital lesion as well as image quality and presence of artifacts. Comparison between both datasets was made using Fisher exact test. RESULTS Seven patients (4 women, 3 men) with a median age of 52 years were enrolled. Orbital lesion conspicuity was better scored at 7 T compared to 3 T MRI, with 3/7 lesions (43%) scored as very conspicuous at 7 T compared to 0/7 lesion (0%) at 3 T, although the difference was not significant (P = 0.16). Delineation of lesion margins was better scored at 7 T compared to 3 T with 3/7 lesions (43%) scored as very well delineated on 7 T compared to 0/7 lesions (0%) at 3 T, although the difference was not significant (P = 0.34). Details of internal structure were better assessed at 7 T compared to 3 T, with 4/7 lesions (57%) displaying numerous internal details compared to 0/7 lesions (0%) at 3 T (P = 0.10). Internal microvessels were visible in 3/7 lesions (43%) at 7 T compared to 0/7 lesions (0%) at 3 T (P = 0.19). CONCLUSION Although no significant differences were found between 7 T and 3 T MRI, assumably due to a limited number of patients, our study suggests that 7 Tesla MRI might help improve the characterization of orbital lesions. However, further studies with more patients are needed.
Collapse
Affiliation(s)
- Augustin Lecler
- Department of Neuroradiology, Foundation Adolphe de Rothschild Hospital, 75019 Paris, France; Université Paris Cité, Faculté de Médecine, 75006 Paris, France.
| | - Loïc Duron
- Department of Neuroradiology, Foundation Adolphe de Rothschild Hospital, 75019 Paris, France
| | - Emily Charlson
- Department of Ophthalmology, Byers Eye Institute, Stanford Hospital, 94305 Stanford, CA, USA
| | - Clint Kolseth
- Department of Ophthalmology, Byers Eye Institute, Stanford Hospital, 94305 Stanford, CA, USA
| | - Andrea L Kossler
- Department of Ophthalmology, Byers Eye Institute, Stanford Hospital, 94305 Stanford, CA, USA
| | - Max Wintermark
- Department of Neuroradiology, Stanford Hospital, 94305 Stanford, CA, USA
| | - Kevin Moulin
- Lucas Center for Imaging, 94305 Stanford, CA, USA
| | - Brian Rutt
- Lucas Center for Imaging, 94305 Stanford, CA, USA
| |
Collapse
|
4
|
Chung HU, Son JH. Ocular adnexal lymphoma: an updated review of pathogenesis, diagnosis, and treatment. Yeungnam Univ J Med 2021; 39:3-11. [PMID: 34521183 PMCID: PMC8895963 DOI: 10.12701/yujm.2021.01263] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 08/12/2021] [Indexed: 12/02/2022] Open
Abstract
Lymphoma is the most common primary tumor of the orbit, accounting for 55% of all orbital malignancies. When divided into histopathological subtypes, extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) comprises the largest proportion. Clinical manifestations are unspecific, but in patients with slow-growing painless orbital mass, or red conjunctival lesion suggestive of ‘salmon patch’, ocular adnexa lymphoma (OAL) should be suspected. Although the pathogenetic mechanism of ocular adnexal MALT lymphoma (OAML) is not yet fully understood, the relationship between OAML and Chlamydia psittaci has been hypothesized recently, similar to that between gastric MALT lymphoma and Helicobacter pylori. This suggests a new treatment option for OAML; bacterial eradication therapy with systemic antibiotics. Several other treatment methods for OAML have been introduced, but no treatment guidelines have been established yet. In this article, we summarize the current knowledge on the clinical features, pathogenesis, diagnostic methods, therapeutic strategies, and prognosis of OAML.
Collapse
Affiliation(s)
- Hyun Uk Chung
- Yeungnam Eye Center, Yeungnam University Hospital, Daegu, Korea
| | - Jun Hyuk Son
- Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea
| |
Collapse
|
5
|
Lecler A, Duron L, Zmuda M, Zuber K, Bergès O, Putterman M, Savatovsky J, Fournier L. Intravoxel incoherent motion (IVIM) 3 T MRI for orbital lesion characterization. Eur Radiol 2021; 31:14-23. [PMID: 32740820 DOI: 10.1007/s00330-020-07103-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 04/28/2020] [Accepted: 07/22/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To determine the diagnostic accuracy of MRI intravoxel incoherent motion (IVIM) when characterizing orbital lesions, which is challenging due to a wide range of locations and histologic types. METHODS This IRB-approved prospective single-center study enrolled participants presenting with an orbital lesion undergoing a 3-T MRI prior to surgery from December 2015 to July 2019. An IVIM sequence with 15 b values ranging from 0 to 2000 s/mm2 was performed. Two neuroradiologists, blinded to clinical data, individually analyzed morphological MRIs. They drew one region of interest inside each orbital lesion, providing apparent diffusion coefficient (ADC), true diffusion coefficient (D), perfusion fraction (f), and pseudodiffusion coefficient (D*) values. T test, Mann-Whitney U test, and receiver operating characteristic curve analyses were performed to discriminate between orbital lesions and to determine the diagnostic accuracy of the IVIM parameters. RESULTS One hundred fifty-six participants (84 women and 72 men, mean age 54.4 ± 17.5 years) with 167 orbital lesions (98/167 [59%] benign lesions including 54 orbital inflammations and 69/167 [41%] malignant lesions including 32 lymphomas) were included in the study. ADC and D were significantly lower in malignant than in benign lesions: 0.8 × 10-3 mm2/s [0.45] versus 1.04 × 10-3 mm2/s [0.33], p < 0.001, and 0.75 × 10-3 mm2/s [0.40] versus 0.98 × 10-3 mm2/s [0.42], p < 0.001, respectively. D* was significantly higher in malignant lesions than in benign ones: 12.8 × 10-3 mm2/s [20.17] versus 7.52 × 10-3 mm2/s [7.57], p = 0.005. Area under curve was of 0.73, 0.74, 0.72, and 0.81 for ADC, D, D*, and a combination of D, f, and D*, respectively. CONCLUSIONS Our study showed that IVIM might help better characterize orbital lesions. KEY POINTS • Intravoxel incoherent motion (IVIM) helps clinicians to assess patients with orbital lesions. • Intravoxel incoherent motion (IVIM) helps clinicians to characterize orbital lymphoma versus orbital inflammation. • Management of patients becomes more appropriate.
Collapse
|
6
|
Thompson LDR, Liou SS, Feldman KA. Orbit Solitary Fibrous Tumor: A Proposed Risk Prediction Model Based on a Case Series and Comprehensive Literature Review. Head Neck Pathol 2020; 15:138-152. [PMID: 32529350 PMCID: PMC8010011 DOI: 10.1007/s12105-020-01184-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 05/28/2020] [Indexed: 02/07/2023]
Abstract
Solitary fibrous tumors (SFTs) of the orbit are rare. In order to further characterize the clinical and pathologic features of solitary fibrous tumor arising at this anatomic site, 12 cases of orbital SFTs were analyzed in conjunction with a review of 263 cases reported from the English literature in order to develop a risk prediction model. SFTs of the orbit were equally distributed between males (n = 5) and females (n = 7) with a mean patient age of 46.8 years (median 44.5 years; range 18-76 years) at initial diagnosis. The patients typically presented with swelling or mass around the orbit, with proptosis (n = 10), ptosis (n = 5), and visual changes (n = 6). Tumors were orbital (n = 10) or upper eyelid (n = 2). Mean tumor size was 2.5 cm (median 2.6 cm). Microscopically, the tumors were characterized by cytologically bland spindle cells with patternless growth, hypocellular and hypercellular areas, variable amounts of collagen, and ectatic, branching blood vessels. By immunohistochemistry, all cases had a strong nuclear STAT6 expression. All patients were initially managed with excision or biopsy, three with presurgical embolization. The two patients with biopsy only had persistent disease (mean 37.2 months), but a third patient developed distant bone metastasis at 86.9 months. Overall mean follow-up was 73.1 months: 9 patients are alive or dead without disease (mean 77.9 months), two patients with persistent disease, and one patient with metastatic disease at last follow-up (102 months). Incorporating cases sufficiently reported in the literature, a risk prediction model based on age > 45 years, tumor size > 3 cm, tumor necrosis, mitoses of > 4/2 mm2, moderate to high cellularity, and moderate to severe pleomorphism allows for risk stratification for the development of local recurrence and distant metastasis. In conclusion, orbital SFTs are rare, but can be reliably diagnosed based on the presence of characteristic morphologic features and STAT6 immunohistochemistry. Orbital tumors tend to show a higher frequency of local recurrence than distant metastasis, which can be predicted by a risk stratification model unique to orbital tumors. With late disease common, long term clinical follow-up is recommended.
Collapse
Affiliation(s)
- Lester D. R. Thompson
- Department of Pathology, Southern California Permanente Medical Group, 5601 De Soto Avenue, Woodland Hills, CA 91365 USA
| | - Sofia S. Liou
- Department of Pathology, University of California: Los Angeles, Los Angeles, CA USA
| | - Kenneth A. Feldman
- Department of Ophthalmology, Southern California Permanente Medical Group, Harbor City, CA USA
| |
Collapse
|
7
|
Cui Y, Li Y, Hou ZJ, Ding JW, Li DM. [Clinical features and surgical management of orbitotemporal neurofibromatosis]. Zhonghua Yan Ke Za Zhi 2019; 55:828-833. [PMID: 31715679 DOI: 10.3760/cma.j.issn.0412-4081.2019.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To report the clinical features and surgical treatment of orbitotemporal neurofibromatosis. Methods: It was a retrospective case series study. The clinical records of 24 patients who were treated for orbitotemporal neurofibromatosis between April 2007 and July 2017 at Beijing Tongren Hospital, Capital Medical University were analyzed. Data collected included sex, age, laterality, periorbital deformities, surgical treatment, follow-up time, complication and recurrence. Results: Sixteen males and 8 females were included. Age at surgery was (15±7) years (4-30 years). All patients were unilaterally involved. Twenty-three patients (96%) had upper lid involvement and ptosis. Nine patients (38%) had lower lid involvement. Fourteen patients (58%) had lateral canthal disinsertion. Three patients (13%) had brow involvement, 10 patients (42%) had conjunctival involvement and 2 patients (8%) had lacrimal gland infiltration. All patients had tumor debulking procedure. Twenty-two patients (92%) had correction of ptosis. Fourteen patients (58%) required lid reconstruction and lateral canthus reattachment surgery. Three patients (13%) had correction of brow ptosis.One patient (4%) had skull and orbit reconstruction. The median follow-up time was 3.5 (1.0-10.0) years. All patients had improved appearance. Ptosis recurred in 6 patients, but were corrected with surgery. On the last follow-up, 7 patients were free of ptosis. In 14 patients, mild ptosis was noted, but the upper lid did not cover the pupil. In 2 patients the pupil was half covered. Only in 1 patient who had not received ptosis correction surgery the pupil was covered completely. Conclusions: The periorbital deformities of orbitotemporal neurofibromatosis include upper eyelid infiltration with ptosis, lateral canthal disinsertion and infiltration of lower eyelid, brow, conjunctiva and lacrimal gland. The appearance of patients with orbitotemporal neurofibromatosis can be significantly improved through oculoplastic surgery. (Chin J Ophthalmol, 2019, 55: 828-833).
Collapse
Affiliation(s)
- Y Cui
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Lab., Beijing 100730, China
| | | | | | | | | |
Collapse
|
8
|
Cruzado-Sánchez D, Sánchez-Ortiz J, Peralta CI, Tellez WA, Maquera-Torres G, Serpa-Frías S. Orbital metastasis diagnosed by ultrasound-guided fine-needle aspiration biopsy: Case report of unknown primary site. ACTA ACUST UNITED AC 2019; 94:566-570. [PMID: 31378389 DOI: 10.1016/j.oftal.2019.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 07/01/2019] [Accepted: 07/02/2019] [Indexed: 11/25/2022]
Abstract
Twenty five percent of orbital metastasis is usually of unknown primary origin and it requires histopathological and immunohistochemical confirmation. The fine-needle aspiration biopsy of the orbit is an alternative procedure to conventional orbitotomy. The case is presented of a 60 year-old woman with a right orbit tumour mass and neoplastic lesions in her brain and cranium. As an incidental finding, she had a thrombus in her left atrium, and so an orbitotomy procedure was ruled out. An ultrasound-guided fine-needle aspiration biopsy was performed instead with rapid on-site evaluation of biopsy samples. These showed malignant cells of a lung adenocarcinoma, which was confirmed with immunohistochemistry and chest diagnostic images. In conclusion, biopsy samples obtained by fine-needle aspiration biopsy, together with cytopathological and immunohistological analysis, enabled orbital metastasis to be identified in the case described, and showed that fine-needle aspiration biopsy is a safe, effective, and minimally invasive alternative.
Collapse
Affiliation(s)
- D Cruzado-Sánchez
- Servicio de Oncología Ocular, Instituto Nacional de Enfermedades Neoplásicas (INEN), Lima, Perú.
| | - J Sánchez-Ortiz
- Servicio de Oftalmología, Hospital Nacional Cayetano Heredia, Lima, Perú
| | - C I Peralta
- Sociedad Científica de Estudiantes de Medicina Villarrealinos (SOCEMVI), Universidad Nacional Federico Villarreal, Lima, Perú
| | - W A Tellez
- Sociedad Científica de Estudiantes de Medicina Villarrealinos (SOCEMVI), Universidad Nacional Federico Villarreal, Lima, Perú
| | - G Maquera-Torres
- Servicio de Patología, Instituto Nacional de Enfermedades Neoplásicas (INEN), Lima, Perú
| | - S Serpa-Frías
- Servicio de Oncología Ocular, Instituto Nacional de Enfermedades Neoplásicas (INEN), Lima, Perú
| |
Collapse
|
9
|
Abstract
For removal of tumors and foreign bodies from the orbit, for treatment of severe inflammatory diseases, and for repositioning of bone fragments following fractures or during reconstruction of the bony orbit, several different surgical approaches are available. During the past decade, improved understanding of the pathology and pathophysiology of particular orbital diseases, advancements in clinical endoscopy and microscopy, the introduction of modern imaging techniques for preoperative visualization of pathologic findings, modern approaches to orbital reconstruction, as well as developments in adjuvant therapy have led to a reduction in invasiveness and development of the modern minimally invasive surgical approaches to the orbit usually used today. This review article aims to describe several surgical approaches to the orbit that are nowadays commonly applied-frequently in the context of interdisciplinary therapy-as well as their indications and potential complications. Particular attention is paid to minimally invasive approaches. These different surgical approaches allow a 360-degree exposure of the internal orbital structures with the optic nerve at the center ("round the clock access to the orbit"). The review is complemented by hints and tricks for particular approaches, as well as by a review of the latest literature in the field.
Collapse
Affiliation(s)
- H-J Welkoborsky
- HNO-Klinik, Kopf- und Halschirurgie, regionale plastische Chirurgie, Klinikum Nordstadt, KRH GmbH, Haltenhoffstraße 41, 30167, Hannover, Deutschland.
| | - S K Plontke
- Universitätsklinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Universitätsklinikum Halle (Saale), Halle (Saale), Deutschland
| |
Collapse
|
10
|
Abstract
Objective: To evaluate the clinicopathological features of ocular natural killer(NK)/T cell lymphoma. Methods: Data of 21 patients (22 eyes) with ocular NK/T cell lymphoma treated at Eye & ENT Hospital of Fudan University from January 2006 to March 2018 were retrospectively analyzed for clinical data, morphology, immunophenotype and outcomes. Results: There were 10 males and 11 females with ages from 3 to 77 years (mean, 43 years). There were 20 unilateral cases (10 left eyes and 10 right eyes) and 1 bilateral case. Except for 1 case of corneal perforation resulting from the involvement of the conjunctiva and cornea, the other cases all involved the orbit (including eyelids and conjunctiva) as demonstrated by radiologic studies, with the lacrimal sac involved in 3 cases, and the nasal cavity or maxillary sinus involved in 2 cases. Three patients had been previously diagnosed sinonasal NK/T cell lymphoma with radiotherapy and chemotherapy. Two patients had a history of ovarian NK/T cell lymphoma with chemotherapy. One patient had multiple ulcers of skin and mucosa at presentation. There were 13 primary ocular NK/T cell lymphomas without evidence of nasal or systemic involvement. All patients presented with eyelid swelling and decreased visual acuity. There were proptosis in 18 cases, motility restriction in 13 cases, eyelid ulceration in 3 cases, and fever in 4 cases. They had all been previously diagnosed as orbital pseudotumor or cellulitis and there was no response to steroids and antibiotics. Pathological examination showed atypical lymphoid infiltration with an angioinvasive growth pattern causing coagulative necrosis. Cytologically, the medium-sized neoplastic cells showed irregular folded nuclei. The neoplastic cells were positive for cytoplasmic CD3ε, CD56, and cytotoxic molecules and Epstein-Barr virus-encoded RNA (EBER) in situ hybridization. Seven patients were lost to follow-up. Ten patients died 2.0 to 17.0 months after diagnosis (mean, 6.3 months) despite treatment with chemotherapy and radiotherapy. Conclusions: Ocular NK/T cell lymphoma is a rare form of ocular lymphoma. There are primary NK/T cell lymphoma and secondary ocular NK/T cell lymphoma with nasal or systemic involvement. The rarity of this tumor and inflammatory signs make it challenging to identify these tumors early. The neoplastic cells are positive for cytoplasmic CD3ε, CD56, cytotoxic molecules and EBER in situ hybridization. Despite aggressive therapy, it demonstrates high lethality with poor prognosis. (Chin J Ophthalmol, 2019, 55: 374-380).
Collapse
Affiliation(s)
- Y W Bi
- Department of Pathology, Eye & ENT Hospital of Fudan University, Shanghai 200031, China
| | - S Y Wang
- Department of Pathology, Eye & ENT Hospital of Fudan University, Shanghai 200031, China
| | - J Qian
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai 200031, China
| | - Y F Yuan
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai 200031, China
| | - X Q Li
- Department of Pathology, Cancer Hospital, Fudan University, Shanghai 200032, China
| | - X Z Zhu
- Department of Pathology, Cancer Hospital, Fudan University, Shanghai 200032, China
| |
Collapse
|
11
|
Lee B, Park SJ, Moon JH, Kim SH, Chang JH, Kim SH, Kim EH. Angioleiomyoma in the Orbital Apex: A Case Report. Brain Tumor Res Treat 2019; 7:156-159. [PMID: 31686449 PMCID: PMC6829078 DOI: 10.14791/btrt.2019.7.e30] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 05/01/2019] [Accepted: 06/11/2019] [Indexed: 01/16/2023] Open
Abstract
A 56-year woman presented eyeball pain and blurred vision. MRI revealed a small well-delineated solid tumor in the apex of right orbit with optic nerve compression. Intraoperatively, the tumor was found very fibrous, hypervascular and adhesive to surrounding structures. The tumor was completely removed with the combination of endoscopic and microscopic technique. Patient experienced transient oculomotor nerve palsy, which completely recovered 3 months after surgery. Herein we report a rare case of angioleiomyoma in the orbital apex.
Collapse
Affiliation(s)
- Boeun Lee
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea
| | - Soo Jeong Park
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.,Brain Tumor Center, Severance Hospital, Seoul, Korea
| | - Ju Hyung Moon
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.,Brain Tumor Center, Severance Hospital, Seoul, Korea.,Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Se Hoon Kim
- Brain Tumor Center, Severance Hospital, Seoul, Korea.,Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Hee Chang
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.,Brain Tumor Center, Severance Hospital, Seoul, Korea.,Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Sun Ho Kim
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.,Brain Tumor Center, Severance Hospital, Seoul, Korea.,Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Eui Hyun Kim
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.,Brain Tumor Center, Severance Hospital, Seoul, Korea.,Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
| |
Collapse
|
12
|
Coutinho I, Marques M, Almeida R, Custódio S, Simões Silva T, Águas F. Extraocular Muscles Involvement as the Initial Presentation in Metastatic Breast Cancer. J Breast Cancer 2018; 21:339-342. [PMID: 30275864 PMCID: PMC6158159 DOI: 10.4048/jbc.2018.21.e46] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 06/02/2018] [Indexed: 11/30/2022] Open
Abstract
Orbital metastasis is a rare event, and metastatic disease affecting the extraocular muscles is an even less frequent complication of solid tumors. Herein, we report an unusual case of ptosis as the initial presentation of an invasive breast cancer. A 68-year-old woman presented with III and VI partial nerve paresis, secondary to a compressive retrobulbar mass. Magnetic resonance imaging revealed an infiltrative lesion involving the extraocular muscles. Tissue biopsy yielded a result compatible with metastasis to the orbit, with immunohistochemistry analysis suggesting breast as the primary organ. Mammography identified an area of architectural distortion; stereotactic wire-guided biopsy confirmed the result of the previous orbital biopsy. A positron emission tomography scan demonstrated disseminated disease. Palliative chemotherapy with bone-modulating agents and subsequent hormonal therapy was proposed. Unfortunately, the patient did not respond to therapy and died 38 months after diagnosis.
Collapse
Affiliation(s)
- Inês Coutinho
- Department of Gynaecology, Coimbra University Hospital Centre, Coimbra, Portugal
| | - Marco Marques
- Department of Ophthalmology, Coimbra University Hospital Centre, Coimbra, Portugal
| | - Rui Almeida
- Department of Pathological Anatomy, Coimbra University Hospital Centre, Coimbra, Portugal
| | - Sofia Custódio
- Department of Gynaecology, Coimbra University Hospital Centre, Coimbra, Portugal
| | - Teresa Simões Silva
- Department of Gynaecology, Coimbra University Hospital Centre, Coimbra, Portugal
| | - Fernanda Águas
- Department of Gynaecology, Coimbra University Hospital Centre, Coimbra, Portugal
| |
Collapse
|
13
|
Huang XM, Wang D, Lin JY, Tang DR, Sun FY. [Clinical analysis of orbital ectopic meningiomas]. Zhonghua Yan Ke Za Zhi 2018; 54:665-70. [PMID: 30220181 DOI: 10.3760/cma.j.issn.0412-4081.2018.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the clinical features, imaging features, diagnoses and therapeutic regimens of orbital ectopic meningiomas. Methods: A retrospective study. All the clinical data of 10 patients (10 eyes) with orbital ectopic meningiomas were analyzed retrospectively from August 1999 to October 2016. They included imaging data such as color Doppler ultrasound, CT and MRI, and information of diagnosis, pathology, therapeutic regimen and prognosis. Results: The age of orbital ectopic meningiomas was 7 to 68 years old. There were 4 males and 6 females. The clinical manifestations were mainly with swollen eyelid (8 cases), exophthalmos (7 cases), visual impairment (2 cases) and accidentally found a mass in the orbit with physical examination(2 cases). The tumor was located in (5 cases) or outside (5 cases) the muscular funnel of the orbit. The imaging features of CT included the irregular shape, unclear border, and extraocular muscular adhesions (10 cases). T1 weighted image of MRI showed low and medium signals and T2 weighted image showed medium and high signals(8 cases). There was no definite diagnosis before surgery. Ten patients were treated with surgery, and it was confirmed intraoperatively that the tumors were not adjacent to the optic nerve and orbital periosteum. The pathological diagnoses were mostly epithelial meningiomas (9 cases). There were no significant changes in visual acuity, but temporary eye movement disorders occurred postoperatively (10 cases). The patients were followed for 6 months to 6 years. Two cases underwent recurrent at 3 months and 2 years after operation, and received treatment of γ-knife radiation therapy. The tumor reduced after γ-knife radiotherapy, and had no change in 2 years and 6 years, respectively. Conclusions: As a kind of rare orbital tumors, it is difficult to diagnose orbital ectopic meningiomas accurately. The clinical features and imaging findings can help to detect the disease, but lacking the characteristics of optic nerve sheath meningiomas and periosteal meningiomas. Surgical resection could achieve a good prognosis without visual impairment. If the tumor recurs after pathological diagnosis, γ-knife conformal radiation therapy may still be effective for tumor recurrence. (Chin J Ophthalmol, 2018, 54: 665-670).
Collapse
|
14
|
Wang SY, Wang D, Zhang WX, He PF. [A case report of small cell lung cancer with orbital metastasis as the first presentation]. Zhonghua Zhong Liu Za Zhi 2018; 40:638-639. [PMID: 30139038 DOI: 10.3760/cma.j.issn.0253-3766.2018.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- S Y Wang
- Department of Cardiothoracic Surgery, Zhangye People's Hospital Affiliated to Hexi University, Zhangye 734000, China
| | - D Wang
- Department of Cardiothoracic Surgery, Zhangye People's Hospital Affiliated to Hexi University, Zhangye 734000, China
| | - W X Zhang
- Department of Cardiothoracic Surgery, Zhangye People's Hospital Affiliated to Hexi University, Zhangye 734000, China
| | - P F He
- Department of Cardiothoracic Surgery, Zhangye People's Hospital Affiliated to Hexi University, Zhangye 734000, China
| |
Collapse
|
15
|
Zhao Y, Li HQ, Zhao H, Pan Y. [Diagnostic and therapeutical analysis of orbital neurilemomas]. Zhonghua Yan Ke Za Zhi 2018; 54:509-514. [PMID: 29996612 DOI: 10.3760/cma.j.issn.0412-4081.2018.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore and summarize the clinical manifestation, iconographic characterizations, principles of diagnosis and treatment of orbital neurilemomas. Methods: Retrospective case series study. A total of 112 patients diagnosed with orbital neurilemomas and received surgery at Tianjin Eye Hospital from January 2002 to December 2016 were included. The clinical symptoms, eye signs, imageological examination, diagnosis treatment and prognosis of the patients were analyzed. SPSS 21.0 software was used to describe age and follow-up time. Results: In the 112 cases, 48 cases were male, 64 cases were female. At the time of diagnosis, the age of patients ranged from 13 to 73 years. The mean age at diagnosis was (40±4) years. B ultrasound scan was applied in all 112 cases, results revealed round, elliptical, beaded, and irregular shaped lesion in orbit with clear boundary, which was characterized with poor echo, strong sonolucency, and mild compressibility. CT scan was also applied in all 112 cases. The lesions were elliptical, lobulated, S-shaped, or peanut shaped, primarily characterized with evenly high density and a few with the low density fluidized region. MRI was applied in 54 cases. T(1) weighted image (T(1)WI) showed medium signal in all lesions. T(2) weighted image (T(2)WI) showed high, mixed and medium signal. Surgical approaches included lateral orbitotomy in 75 cases, and anterior orbitotmy in 37 cases. Average follow-up time was (64.3±4.1) months. Surgical complications included vison loss (in 3 cases), postoperation ptosis (in 16 cases), and disturbance of eyeballs movement (in 9 cases), while 6 cases involved with recurrence. Conclusions: Orbital schwannoma is mostly characterized with benign solid orbital lesions. Orbital CT examination results of orbital schwannoma are mainly characterized with ellipsoid or beaded mass along the anterior posterior axis of orbit, while a few of tumors showed low density liquefaction areas. T(1)WI shows medium signal in most lesions, and T(2)WI shows mixed signal in most lessions. Histopathologic examination is the basis for confirmation of diagnosis. The recurrence rate is lower after the complete resection of the tumor. Postoperative radiotherapy could be used for controlling the recurrence. (Chin J Ophthalmol, 2018, 54: 509-514).
Collapse
Affiliation(s)
- Y Zhao
- Tianjin Eye Hospital and Institute, Clinical College of Ophthalmology of Tianjin Medical University, Tianjin Key Laboratory of Ophthalmology and Vision Science, Tianjin 300020, China
| | | | | | | |
Collapse
|
16
|
Guo J, Liu Z, Shen C, Li Z, Yan F, Tian J, Xian J. MR-based radiomics signature in differentiating ocular adnexal lymphoma from idiopathic orbital inflammation. Eur Radiol 2018; 28:3872-3881. [PMID: 29632999 DOI: 10.1007/s00330-018-5381-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 02/06/2018] [Accepted: 02/08/2018] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To assess the value of the MR-based radiomics signature in differentiating ocular adnexal lymphoma (OAL) and idiopathic orbital inflammation (IOI). METHODS One hundred fifty-seven patients with pathology-proven OAL (84 patients) and IOI (73 patients) were divided into primary and validation cohorts. Eight hundred six radiomics features were extracted from morphological MR images. The least absolute shrinkage and selection operator (LASSO) procedure and linear combination were used to select features and build radiomics signature for discriminating OAL from IOI. Discriminating performance was assessed by the area under the receiver-operating characteristic curve (AUC). The predictive results were compared with the assessment of radiologists by chi-square test. RESULTS Five radiomics features were included in the radiomics signature, which differentiated OAL from IOI with an AUC of 0.74 and 0.73 in the primary and validation cohorts respectively. There was a significant difference between the classification results of the radiomics signature and those of a radiology resident (p < 0.05), although there was no significant difference between the results of the radiomics signature and those of a more experienced radiologist (p > 0.05). CONCLUSIONS Radiomics features have the potential to differentiate OAL from IOI. KEY POINTS • Clinical and imaging findings of OAL and IOI often overlap, which makes diagnosis difficult. • Radiomics features can potentially differentiate OAL from IOI non invasively. • The radiomics signature discriminates OAL from IOI at the same level as an experienced radiologist.
Collapse
Affiliation(s)
- Jian Guo
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, No. 1 of Dongjiaominxiang, Dongcheng District, Beijing, 100730, China
| | - Zhenyu Liu
- CAS Key Laboratory of Molecular Imaging, Institute of Automation, Beijing, 100190, China
| | - Chen Shen
- School of Life Science and Technology, Xidian University, Xi'an, Shanxi, 710126, China
| | - Zheng Li
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, No. 1 of Dongjiaominxiang, Dongcheng District, Beijing, 100730, China
| | - Fei Yan
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, No. 1 of Dongjiaominxiang, Dongcheng District, Beijing, 100730, China
| | - Jie Tian
- CAS Key Laboratory of Molecular Imaging, Institute of Automation, Beijing, 100190, China. .,University of Chinese Academy of Sciences, Beijing, 100049, China.
| | - Junfang Xian
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, No. 1 of Dongjiaominxiang, Dongcheng District, Beijing, 100730, China.
| |
Collapse
|
17
|
Wu XW, Zhang H, Jiang WH, Zhang JY, Xie ZH, Peng ZY, Sun H. [Clinical practice of transnasal endoscopic operation for retrobulbar lesions]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2017; 52:648-653. [PMID: 28910887 DOI: 10.3760/cma.j.issn.1673-0860.2017.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To summarize the skill and experience of transnasal endoscopic operation for retrobulbar lesions. Methods: Seven patients aged from 25 to 67 years old diagnosed as retrobulbar lesions who underwent transnasal endoscopic operation in Department of Otorhinolaryngology Head and Neck Surgery, Xiangya Hospital between January 2013 and October 2016 were retrospectively analyzed. Two males and five females were included in this study. Five patients underwent transnasal endoscopic operation via media rectus-inferior rectus space, with the other 2 cases via media rectus-superior rectus space. Results: Total lesion removal was achieved in 6 of 7 patients, while 1 patient underwent subtotal removal of the lesion. The visual acuity and visual field improved in 3 cases. The pathological examination showed hemangioma(5 cases), bone cyst(1 case) and fibroma(1 case). All patients were followed up for 9 months to 4 years without complications such as eye movement disorder or blindness, except for 1 case with preoperatively proptosis occurred postoperatively transient diplopia. There was no recurrence in 6 patients with total lesion removal, and the patient underwent subtotal removal of fibroma did not undertake operation again. Conclusion: Transnasal endoscopic operation for retrobulbar lesions is a minimally invasive, safe and effective operatiiv method, which could be taken via different surgical approaches according to the size and location of the lesion.
Collapse
Affiliation(s)
- X W Wu
- Department of Otorhinolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha 410008, China
| | - H Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha 410008, China
| | - W H Jiang
- Department of Otorhinolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha 410008, China
| | - J Y Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Z H Xie
- Department of Otorhinolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Z Y Peng
- Department of Otorhinolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha 410008, China
| | - H Sun
- Department of Otorhinolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha 410008, China
| |
Collapse
|
18
|
Liao HF, Wang YH, Huang Q, Gan PY, Wang AA. [Analysis of the effect of different surgical methods on the cavernous hemangioma of the deep orbit]. Zhonghua Yan Ke Za Zhi 2017; 53:288-293. [PMID: 28412802 DOI: 10.3760/cma.j.issn.0412-4081.2017.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the effect of the surgical removal of orbital deep cavernous hemangioma following the concept of minimal surgical invasion. Methods: Retrospective case series study. Sixty-three cases with surgical removal of deep orbital cavernous hemangioma were collected in the Affiliated Eye Hospital of Nanchang University from May 2012 to August 2015. There were 29 males and 34 females. The age was from 17 to 69 years with mean age (45±11) years.The surgical methods the conjunctival approach orbital surgery, lateral orbital surgery, medial skin orbital surgery, lateral orbital conjunctiva conjunctival pathway and endoscopic nasal approach were chosen for different cases. The visual acuity, visual field and electrophysiological examination were analyzed before and after operation. Result: Sixty-three patients underwent complete surgically removal of the tumor. Among them, 32 cases were conducted by conjunctival approach, 24 cases had improved visual acuity, 5 cases had no change of visual acuity, 3 cases had decreased visual acuity. Seventeen cases performed with lateral open orbital surgery had improved visual acuity in 11 cases, no change in visual acuity in 3 cases and decreased visual acuity in 3 cases postoperatively. Six cases with approach of the medial orbital surgery had improved visual acuity in 4 cases, no change of visual acuity in 1 case and decreased visual acuity in 1 case postoperatively. Six cases with approach of outside open orbital surgery combined with medial conjunctival pathway had improved visual acuity in 4 cases, no change of visual acuity in 1 case and decreased visual acuity in 1 case postoperatively. Two cases performed with endoscopic nasal approach. One of them had normal visual function and no change after surgery. Another had impaired visual function pre-operatively and it came back to normal postoperatively. Conclusions: With the concept of minimal surgical invasion, the choice of appropriate surgical approach can save patients with the greatest degree of visual function and even improve the visual function of the patients with orbital cavernous hemangioma. (Chin J Ophthalmol, 2017, 53: 288-293).
Collapse
Affiliation(s)
- H F Liao
- Affiliated eye hospital of Nanchang University, Nanchang 330000, China
| | | | | | | | | |
Collapse
|
19
|
Shi YY, Jia RB, Fan XQ. [The progress in the diagnosis and management of orbital lymphoma]. Zhonghua Yan Ke Za Zhi 2017; 53:632-636. [PMID: 28851203 DOI: 10.3760/cma.j.issn.0412-4081.2017.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Lymphoma is one of the most common malignant tumor of the orbit in adults. Orbital lymphoma mainly consists of extranodal marginal zone B cell lymphoma of mucosa-associated lymphoid tissue, follicular lymphoma, diffuse large B-cell lymphoma, mantle cell lymphoma, infrequent NK/T cell lymphoma and Burkitt lymphoma. Diagnosis on orbital lymphoma remains challenging in that it is difficult to distinguish it from benign lesions, especially for low degree lymphomas. Combined examinations of histological, cytological and molecular features are required to make final differentiation. There are many treatment options for diagnosis of orbital lymphoma, such as surgical resection, radiotherapy, chemotherapy, monoclonal antibody targeted therapy, immunotherapy. The appropriate scenario of treatment on orbital lymphoma should be made based on the Ann Arbor or TNM staging system to determine the stage of orbital lymphoma at the moment for maximizing the results. The latest concepts on diagnosis and management of orbital lymphoma are reviewed in this paper. (Chin J Ophthalmol, 2017, 53: 632-636).
Collapse
Affiliation(s)
- Y Y Shi
- Department of Ophthalmology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medical, Shanghai 200011, China
| | | | | |
Collapse
|
20
|
Aysel A, Göde S, Midilli R, Karcı HB. Reconstruction of Orbital Walls with Bone Cement in a Maxillectomy Patient. Turk Arch Otorhinolaryngol 2015; 53:183-187. [PMID: 29392004 DOI: 10.5152/tao.2015.588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Accepted: 10/08/2014] [Indexed: 11/22/2022] Open
Abstract
Orbital wall defects occur because of trauma and secondary to oncologic surgery. Reconstruction of orbital bones is of most importance to ensure normal eye functions and cosmesis. Acrylic resin materials can be used instead of a bone in orbital wall defects that are secondary to the resection of tumors invading the orbita. Polymethyl methacrylate is one of the acrylic resin materials. In this study, the orbital wall reconstruction technique with bone cement after maxillectomy and results are reported.
Collapse
Affiliation(s)
- Abdülhalim Aysel
- Department of Otorhinolaryngology, Ege University School of Medicine, İzmir, Turkey
| | - Sercan Göde
- Department of Otorhinolaryngology, Ege University School of Medicine, İzmir, Turkey
| | - Raşit Midilli
- Department of Otorhinolaryngology, Ege University School of Medicine, İzmir, Turkey
| | - H Bülent Karcı
- Department of Otorhinolaryngology, Ege University School of Medicine, İzmir, Turkey
| |
Collapse
|
21
|
Jeng Tyng C, Matushita JPK, Bitencourt AGV, Neves FBCS, Amoedo MK, Barbosa PNV, Chojniak R. Uncommon primary tumors of the orbit diagnosed by computed tomography-guided core needle biopsy: report of two cases. Radiol Bras 2015; 47:380-3. [PMID: 25741122 PMCID: PMC4341380 DOI: 10.1590/0100-3984.2013.1888] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Accepted: 01/17/2014] [Indexed: 02/08/2023] Open
Abstract
Computed tomography-guided percutaneous biopsy is a safe and effective alternative
method for evaluating selected intra-orbital lesions where the preoperative diagnosis
is important for the therapeutic planning. The authors describe two cases of patients
with uncommon primary orbital tumors whose diagnosis was obtained by means of
computed tomography-guided core needle biopsy, with emphasis on the technical aspects
of the procedure.
Collapse
Affiliation(s)
- Chiang Jeng Tyng
- Master, Titular Physician and Responsible for the Unit of Percutaneous Intervention, Imaging Department at A.C.Camargo Cancer Center, São Paulo, SP, Brazil
| | | | | | | | | | - Paula Nicole Vieira Barbosa
- Master, Titular Physician and Responsible for the Unit of Computed Tomography, Imaging Department at A.C.Camargo Cancer Center, São Paulo, SP, Brazil
| | - Rubens Chojniak
- PhD, Titular Physician and Director, Department of Imaging, A.C.Camargo Cancer Center, São Paulo, SP, Brazil
| |
Collapse
|
22
|
González-Martínez E, Robla Costales J, Fernández Fernández J, Viñuela Lobo J, Santamarta D, Lomas García J, Iglesias E, Ribas Ariño T, García-Cosamalón J. [Orbital leiomyoma. Case report and review of the literature]. Neurocirugia (Astur) 2014; 25:33-7. [PMID: 23562416 DOI: 10.1016/j.neucir.2013.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Revised: 11/05/2012] [Accepted: 01/20/2013] [Indexed: 11/23/2022]
Abstract
Leiomyoma are slowly growing lesions arising from smooth muscle. Orbital location has been reported in 25 cases. Histological findings and no recurrence after total resection support their benign behaviour. We report an intraconal orbital haemangioleiomyoma in a 55-year-old female treated by total resection through fronto-orbital craniotomy, with no recurrence after 15 months of follow-up. Radiological and pathological features are discussed, emphasising the prognostic role of the surgery.
Collapse
|
23
|
Lee JY, Lee HJ, Jung MS, Kim SY. Metastatic esophageal squamous cell carcinoma to the orbit and periorbit masquerading as periorbital abscess. Korean J Ophthalmol 2010; 24:123-5. [PMID: 20379463 PMCID: PMC2851000 DOI: 10.3341/kjo.2010.24.2.123] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2009] [Accepted: 03/09/2010] [Indexed: 11/23/2022] Open
Abstract
A 61-year-old man with no history of malignancy presented with a rapidly expanding left periorbital mass, first noticed one month prior to presentation. The mass was firm, and a pus-like discharge drained spontaneously from the center of the lesion. A biopsy was performed, and histopathology confirmed squamous cell carcinoma. Systemic evaluation revealed that the patient had a primary esophageal squamous cell carcinoma with multiple metastases. The prognosis of orbital metastasis is generally poor, and this patient expired after one month of conservative treatment.
Collapse
Affiliation(s)
- Ja Young Lee
- Department of Ophthalmology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | | | | | | |
Collapse
|