RESUMO
Mucinous eccrine carcinoma (MEC) is a rare skin cancer of sweat gland origin with a high rate of recurrence. The most common sites are head and neck, with 40% of cancers found on the eyelid. The clinical appearance and differential diagnosis of MEC are highly varied, but histologically it is similar to metastatic carcinomas, specifically breast and colon. A diagnosis of primary MEC always warrants a full systemic workup to ensure that no other malignancy is present. This cancer is known for frequent recurrences, but rarely metastasizes to distant organs. MEC is resistant to both chemotherapy and radiation; surgical excision remains the treatment of choice in most cases. The authors report a unique case of extension of MEC to the lacrimal gland with a brief review of histologic characteristics of this tumor.
Assuntos
Adenocarcinoma Mucinoso/patologia , Neoplasias Oculares/patologia , Sobrancelhas/patologia , Neoplasias Palpebrais/patologia , Doenças do Aparelho Lacrimal/patologia , Recidiva Local de Neoplasia , Neoplasias das Glândulas Sudoríparas/patologia , Adenocarcinoma Mucinoso/cirurgia , Idoso , Neoplasias Palpebrais/cirurgia , Feminino , Humanos , Imageamento por Ressonância Magnética , Cirurgia de Mohs , Invasividade Neoplásica , Neoplasias das Glândulas Sudoríparas/cirurgiaRESUMO
Orbital penetrating injuries are an unfortunately common occurrence; however, those from marine animals are rare. Injuries from marine animals can be quite profound and there are no known reports of complete visual recovery after an orbital penetrating injury. Complications range from secondary infection to a carotid-cavernous fistula, which can complicate the management of these patients. We report a case of penetrating orbital injury from a needlefish with complete return of visual function after surgical removal of foreign debris and an extended course of antibiotics.
Assuntos
Corpos Estranhos/cirurgia , Córtex Pré-Frontal/lesões , Córtex Pré-Frontal/cirurgia , Ferimentos Penetrantes/cirurgia , Adulto , Ampicilina/uso terapêutico , Animais , Antibacterianos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Beloniformes , Cefazolina/uso terapêutico , Ciprofloxacina/uso terapêutico , Diplopia/etiologia , Mergulho/efeitos adversos , Fluoroquinolonas/uso terapêutico , Corpos Estranhos/etiologia , Humanos , Masculino , Militares , Moxifloxacina , Prednisona/uso terapêutico , Tomografia Computadorizada por Raios X/métodos , Ferimentos Penetrantes/etiologiaRESUMO
We present the case of a 78-year-old white woman with a 2+ nuclear sclerotic cataract and pseudoexfoliation syndrome who had cataract extraction with intraocular lens implantation. The initial continuous curvilinear capsulorhexis (CCC) was performed with a cystotome. Due to unusual tearing characteristics, there was concern that the anterior flap was pseudoexfoliative material instead of the lens capsule. Trypan blue was instilled in the anterior chamber, and the staining pattern indicated that the anterior capsule flap had failed to fold on itself initially. A CCC was initiated in the reverse direction and completed without complication. This case illustrates the importance of recognizing the potential for the capsule-splitting phenomenon when performing a CCC in patients with pseudoexfoliation and the important role for capsule staining in these patients.