Assuntos
Adenocarcinoma , Adenoma Pleomorfo , Carcinoma Mucoepidermoide , Doenças do Aparelho Lacrimal , Aparelho Lacrimal , Adenocarcinoma/patologia , Adenoma Pleomorfo/diagnóstico por imagem , Adenoma Pleomorfo/patologia , Adenoma Pleomorfo/cirurgia , Carcinoma Mucoepidermoide/diagnóstico por imagem , Carcinoma Mucoepidermoide/cirurgia , Humanos , Aparelho Lacrimal/diagnóstico por imagem , Aparelho Lacrimal/patologia , Aparelho Lacrimal/cirurgia , Doenças do Aparelho Lacrimal/diagnóstico por imagem , Doenças do Aparelho Lacrimal/patologia , Doenças do Aparelho Lacrimal/cirurgiaRESUMO
PURPOSE: To report the presenting signs of retinoblastoma in a large cohort of patients who underwent orthoptic assessment at presentation. METHODS: A retrospective medical chart review was conducted on 131 patients with retinoblastoma who presented consecutively to a single institution during a 6-year period. The main outcome measure was the presenting sign(s) of the disease. RESULTS: Of 131 patients with retinoblastoma, 88 presented with unilateral disease and 43 presented with bilateral disease (mean ages: 22.7 and 14.8 months, respectively). Leukocoria was the presenting sign in 56% of patients, leukocoria and strabismus in 18%, strabismus in 13%, inflammation in 8%, and "other" signs in 5%. The fovea was affected by the retinoblastoma tumor or its sequelae in 75% of patients. Patients who presented with strabismus were significantly more likely to have foveal involvement than patients who presented with leukocoria alone (P = .001). Thirty-one percent of patients had strabismus as a component of their presentation; 63% had exotropia, 23% had esotropia, and 14% had variable strabismus. The percentage of patients with strabismus increased to 66% when small angle and variable strabismus were also considered. Patients with inflammation had worse ocular survival (P < .05). CONCLUSIONS: This study assessed the combination of leukocoria and strabismus as presenting features of retinoblastoma. Foveal involvement is common in patients who have strabismus and may influence decision-making regarding globe salvage. The authors confirmed that exotropia is more common than esotropia in retinoblastoma in the largest cohort to have undergone an orthoptic assessment. [J Pediatr Ophthalmol Strabismus. 2021;58(5):324-330.].
Assuntos
Distúrbios Pupilares , Neoplasias da Retina , Retinoblastoma , Estrabismo , Humanos , Lactente , Neoplasias da Retina/complicações , Neoplasias da Retina/diagnóstico , Retinoblastoma/complicações , Retinoblastoma/diagnóstico , Estudos Retrospectivos , Estrabismo/diagnóstico , Estrabismo/etiologiaAssuntos
Varíola Bovina/transmissão , Infecções Oculares Virais/etiologia , Orthopoxvirus/isolamento & purificação , Zoonoses Virais/transmissão , Adulto , Animais , Benzamidas/uso terapêutico , Gatos/virologia , Túnica Conjuntiva/virologia , Varíola Bovina/tratamento farmacológico , Olho/patologia , Infecções Oculares Virais/tratamento farmacológico , Infecções Oculares Virais/patologia , Feminino , Humanos , Isoindóis/uso terapêuticoAssuntos
Derivação Arteriovenosa Cirúrgica/efeitos adversos , Veias Braquiocefálicas/patologia , Hipertensão Ocular/etiologia , Diálise Renal/métodos , Transtornos da Visão/etiologia , Braço , Derivação Arteriovenosa Cirúrgica/métodos , Constrição Patológica/etiologia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
A 45-year-old Afro-Caribbean woman attended the emergency department with worsening dysphagia, abdominal distension, abdominal pain, shortness of breath and generalised weakness. She enjoyed preparing and eating cows-feet stew and preferred to cook the meat with the hair and skin intact. On admission she had a severe microcytic anaemia and was malnourished. Abdominal x-ray and CT revealed a large gastric bezoar. At gastrotomy a foul-smelling 2.42 kg mass of hair, leathery skin and altered food were evacuated from the lesser curvature of the stomach. She had undergone the same procedure 8 years earlier to remove a similar trichobezoar. Following psychiatric review it was deemed that the patient had no underlying psychiatric condition and had full insight into why her trichobezoar had re-occurred. She made a good postoperative recovery and stopped eating cows-feet stew.