RESUMEN
Visual recovery after successful surgery for the macula-off rhegmatogenous retinal detachment continues to be an important topic for ophthalmologists. Recent studies have shown that despite the intuitive notion regarding outcomes in macula-off detachment, there is no improvement in final visual acuity despite more expedient repair within the first week. Macula-off detachments can therefore be treated with less urgency and can wait for the next scheduled available operating room time. Surgeons involved in retinal detachment surgery should be aware that visual function based on acuity testing may continue to improve in the long term, most notably in those with the following patient characteristics: younger age, no or mild myopia (less than -5.00 D), and shorter duration of macular detachment (30 days or less).
Asunto(s)
Recuperación de la Función , Retina/fisiopatología , Desprendimiento de Retina/cirugía , Agudeza Visual/fisiología , Humanos , Retina/cirugía , Desprendimiento de Retina/fisiopatología , Factores de Tiempo , Resultado del TratamientoAsunto(s)
Enfermedades de la Coroides/diagnóstico , Cuerpo Ciliar , Glaucoma de Ángulo Cerrado/etiología , Enfermedades de la Úvea/diagnóstico , Adulto , Cámara Anterior/patología , Infecciones por Campylobacter/complicaciones , Infecciones por Campylobacter/diagnóstico , Campylobacter jejuni , Coroides/patología , Enfermedades de la Coroides/patología , Cuerpo Ciliar/patología , Femenino , Glaucoma de Ángulo Cerrado/diagnóstico , Humanos , Oftalmoscopía , UltrasonografíaRESUMEN
PURPOSE: To report a case of small cell carcinoma of the thymus metastatic to the orbit. METHODS: At age 37 years, a man who had been previously diagnosed and treated for small cell carcinoma of the thymus was initially examined for vertical diplopia and left proptosis. Computed tomographic scan disclosed a soft tissue mass in the superior aspect of the left orbit. A fine-needle aspiration biopsy of the mass was performed and submitted for cytopathologic examination. RESULT: The cytopathology and immunopathology disclosed malignant cells consistent with metastatic small cell thymic carcinoma. CONCLUSION: This is the first reported case of a primary thymus gland tumor metastatic to the orbit.
Asunto(s)
Carcinoma de Células Pequeñas/secundario , Neoplasias Orbitales/secundario , Neoplasias del Timo/patología , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Biopsia con Aguja , Carcinoma de Células Pequeñas/diagnóstico por imagen , Carcinoma de Células Pequeñas/patología , Carcinoma de Células Pequeñas/radioterapia , Humanos , Masculino , Neoplasias Orbitales/diagnóstico por imagen , Neoplasias Orbitales/patología , Neoplasias Orbitales/radioterapia , Radioterapia de Alta Energía , Neoplasias del Timo/tratamiento farmacológico , Neoplasias del Timo/radioterapia , Tomografía Computarizada por Rayos XRESUMEN
AIM: Orbital granulocytic sarcoma is a localised tumour composed of cells of myeloid origin. Histological diagnosis can be difficult in patients with poorly differentiated orbital tumours and no evidence of systemic leukaemia. The naphthol AS-D chloracetate esterase (Leder stain) and immunohistochemical stains for lysozyme and MAC387 were used to determine the staining characteristics of these tumours. A case series of seven patients with orbital granulocytic sarcoma is presented. METHODS: Seven patients with orbital granulocytic sarcoma were studied. Haematoxylin and eosin, Leder, and lysozyme stained sections were available in seven cases. Unstained formalin fixed paraffin embedded sections of seven cases were available for immunohistochemical evaluation using the avidin-biotin-complex technique for MAC387. RESULTS: The mean age of presentation of the orbital tumour was 8.8 years. Four patients presented with an orbital tumour before any systemic manifestations of leukaemia. In two cases the diagnosis of the orbital tumour and systemic leukaemia was made simultaneously. There was one case of established systemic myeloid leukaemia in remission with the subsequent development of orbital granulocytic sarcoma. Six of seven cases (86%) were positive for the Leder stain. Five of seven cases (71%) showed positive immunoreactivity with lysozyme. The immunohistochemical stain for MAC387 was positive in all seven cases (100%) including one case that was negative for both lysozyme and Leder stains. CONCLUSIONS: Orbital granulocytic sarcoma is a tumour that affects children and can present with rapidly progressive proptosis. This tumour may develop before, during, or after the occurrence of systemic leukaemia. The combination of Leder and lysozyme stains is useful in the diagnosis of orbital granulocytic sarcoma. MAC387 may be a more reliable marker for orbital granulocytic sarcoma.