Search

Enucleation and primary hydroxyapatite implant placement for unilateral retinoblastoma did not lead to statistically significant orbital volume asymmetry, suggesting that hydroxyapatite implants promote orbital growth comparable to a nonenucleated orbit in the pediatric population.

The authors present an unreported case of malignant conjunctival melanoma with metastasis to the right cardiac atrium. A 67-year-old woman with history of conjunctival melanoma of the OS presented with asymptomatic recurrence with new extension to the fornix. Surgical management was planned; however, the patient was admitted to the hospital with symptoms of heart and respiratory failure. She was found to have a large mass in the right atrium. The mass was resected and was found to be metastatic conjunctival melanoma. The patient received chemotherapy and her symptoms have improved. This case highlights the high recurrence rate of conjunctival melanoma and the importance of tumor surveillance.This case report summarizes a case of conjunctival melanoma with metastasis to the cardiac atrium in a living patient, highlighting the need for life-long surveillance.

To identify the type and frequency of ocular and orbital complications observed following treatment for primary rhabdomyosarcoma of the paranasal sinuses or the orbit.

The authors studied a series of patients with Langerhans cell histiocytosis in an attempt to better define the incidence and significance of orbital involvement within the vast spectrum of the disease.

To compare the difference in volume between enucleated and contralateral, uninvolved orbits in patients with unilateral retinoblastoma treated with primary enucleation who received either hydroxyapatite or solid silicone implants.

To characterize the clinical and imaging features of orbital leukemic tumors in 27 patients seen and treated at St. Jude Children's Research Hospital.

To document the biological tolerance of retained metallic orbital foreign bodies managed with conservative treatment.

To delineate clinical manifestations of fungal orbital cellulitis in immunocompromized patients.

To describe the spectrum of ophthalmic injuries in children involved in all-terrain vehicle (ATV) crashes.

Physical examination of a 9-year-old girl with a 2-month history of swelling of the left orbit demonstrated an orbital mass, blepharoptosis, and proptosis. Computed tomography revealed a 2 × 3-cm mass in the superior left orbit that expanded orbital dimensions. Radiography showed abnormalities in the parietal and frontal bones and distal right tibia. Magnetic resonance imaging demonstrated an 8.5-cm abnormality of the marrow space of the right mid-tibia. Bone marrow biopsy was unremarkable. Orbital and tibial biopsies showed a nonspecific chronic inflammation. Idiopathic inflammation that involves the orbit (orbital pseudotumor) and that has systemic manifestations may mimic more serious conditions, such as metastases from rhabdomyosarcoma or Ewing sarcoma, chronic recurrent multifocal osteomyelitis (CRMO), and SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis). Accurate diagnosis requires careful clinical and pathologic examinations.

A 68-year-old woman experienced an infection of a porous polyethylene orbital implant caused by Capnocytophagaafter a dental procedure. The infection was unresponsive to both topical and oral antibiotics and required removal of the porous polyethylene orbital implant. Capnocytophagais a capnophilic, gram-negative bacillus. Capnocytophagais a normal commensal of the mouth and is responsible for both gingivitis and periodontal disease. Capnocytophagais a rare cause of ocular infections. This is the first reported patient with an infection of a porous polyethylene orbital implant caused by Capnocytophaga.The authors believe infected integrated orbital implants must be removed because neither topical or systemic therapy provide effective treatment.

A 15-year-old boy had bilateral idiopathic orbital inflammation refractory to treatment with corticosteroids. He was not only unresponsive to subsequent therapy with methotrexate but also had elevation of serum liver enzymes. In an attempt to minimize further side effects of corticosteroids and to avoid external beam radiation in an adolescent, we began treatment with infliximab, an anti–tumor necrosis-α antibody. His symptoms resolved and his disease has not recurred. Use of infliximab may be useful in the treatment of recalcitrant idiopathic orbital pseudotumor.

We report a case of a 23-year-old man with primary pelvic telangiectatic osteosarcoma metastatic to both orbits. The patient had proptosis with optic neuropathies and intermittent third nerve palsies. His disease was unresponsive to chemotherapy or radiotherapy, and extensive craniofacial involvement precluded surgical resection. The patient died of his disease. Telangiectatic osteosarcoma, a rare variant of osteosarcoma that is distinguished by blood-filled cystic spaces, may metastasize to the orbit and skull base. Because telangiectatic osteosarcoma may radiographically resemble other benign and malignant lesions, biopsy is essential for accurate diagnosis that will ultimately dictate clinical therapy. However, patients with this disease have a poor prognosis.

A 17-year-old boy diagnosed with an alveolar rhabdomyosarcoma involving the perineum and with extensive lymphadenopathy was treated with chemotherapy yet developed metastases to the head and neck 6 months into therapy. Ten months after initial diagnosis, while receiving salvage chemotherapy and radiotherapy, he returned with pain on movement of his left eye, proptosis, and ptosis of the left upper eyelid. Computed tomography (CT) revealed a mass within the left lateral rectus muscle that biopsy confirmed to be metastatic alveolar rhabdomyosarcoma. Despite continued chemotherapy and radiotherapy, he ultimately died of the disease. Alveolar rhabdomyosarcoma from distant sites rarely metastasizes to the extraocular muscles. However, our case shows that alveolar rhabdomyosarcoma may metastasize to the orbit and involve a single muscle.

We examined a 44-month-old girl with proptosis of the left eye. Magnetic resonance imaging showed a dumbbell-shaped mass involving the cavernous sinus with orbital extension. Biopsy and immunohistochemistry showed the tumor to be a primitive chordoma. Intracranial chordoma should be considered in the differential diagnosis of children with orbital lesions. Immunohistochemistry is helpful in differentiating chordomas from other primitive round-cell or spindle-cell tumors.

A 6-year-old girl with neuroblastoma developed swelling and erythema of her right upper eyelid following administration of an interleukin-2 and lymphotactin gene-modified allogeneic neuroblastoma cell vaccine. Computed tomography demonstrated a cystic lesion in the subperiosteal space. A biopsy of the mass showed necrotic neuroblastoma with minimal associated inflammation. To our knowledge, this case represents the first description of occult orbital metastases in a patient with neuroblastoma detected after administration of an antitumor vaccine.

To report 3 instances of 2 children who swallowed their ocular prostheses.

A 51-year-old woman with a history of migraine headaches was found to have an incidental right orbital mass on MRI during neurologic evaluation for headaches. The orbital mass was a well-defined, lobulated, intraosseous soft tissue lesion with circumscribed margins. Clinically, there was noted proptosis, tenderness to palpation, and slight limitation to right abduction. An orbitotomy with incisional biopsy revealed a lesion arising within the lateral orbital rim extending to the subperiosteal space. Intraoperative frozen sections indicated a low grade sarcoma, possibly metastatic. The extraosseous component was excised, and the bone was curetted until all visible tumor was removed. A diagnosis of chondromyxoid fibroma was made. The patient did well until 5 months postoperatively, when right-sided proptosis returned due to recurrent tumor. Repeat surgical resection with removal of the lateral orbital rim was performed. Histopathology was consistent with recurrent chondromyxoid fibroma.

The authors present a unique case of rapidly progressive proptosis in a woman 23 years after repair of an orbital floor fracture. Clinical studies, surgical exploration, and pathology revealed a hemorrhagic cyst lined with respiratory epithelium surrounding her previously placed silicone implant.