RESUMO
Although liposarcoma is the most prevalent soft tissue sarcoma in adults, head and neck liposarcomas are rare and account for less than 5% of all liposarcomas. The primary orbital location is even more exceptional, with fewer than 100 cases documented in the medical literature. Given the scarcity of cases of orbital liposarcoma and the limited familiarity of physicians and pathologists with this pathology, there is an increased risk of non-diagnosis or misdiagnosis, which may lead to inappropriate patient management. To address these challenges, we present a case of primary orbital myxoid liposarcoma and subsequently discuss the primary findings of this case based on the evidence documented in the medical literature. This comprehensive text is designed to serve as a valuable resource for healthcare professionals and pathologists, with the goal of promoting both clinical suspicion and accurate diagnosis and treatment of this rare condition in future cases.
Assuntos
Lipossarcoma Mixoide , Neoplasias de Tecidos Moles , Adulto , Humanos , Lipossarcoma Mixoide/diagnóstico , Lipossarcoma Mixoide/cirurgia , Lipossarcoma Mixoide/patologia , Neoplasias de Tecidos Moles/diagnóstico , Neoplasias de Tecidos Moles/patologia , Pescoço/patologiaRESUMO
PURPOSE: To describe the primary cancer sites and clinical features of choroidal metastasis in Mexican patients. METHODS: This was a retrospective, observational, and multi-center study. Data were recollected from 6 ophthalmological hospitals in Mexico from patients with choroidal metastasis diagnosed from 2000 to 2018. RESULTS: Seventy-eight patients were studied: 43 were female and 35 were male. Mean age at presentation was 57.6 years. Overall, primary cancer sites were: 1) breast: 27 cases (34.6%); 2) lung: 19 cases (24.3%); 3) unknown: 8 cases (10.2%); 4) gastrointestinal: 7 cases (8.9%); 5) renal: 5 cases (6.4%); 6) testicular: 3 cases (3.8%); 7) ovary: 3 Cases (3.8%); 8) prostate: 2 cases (2.5%); 9) thyroid: 2 cases (2.5%); 10) carcinoid: 1 case (1.2%); and 11) multiple myeloma: 1 case (1.2%). Divided by gender, for women, the main three sites were: breast, unknown, and ovary. For men, the main three sites were: lung, gastrointestinal, and testicular. Oldest cases were breast cancer (87 and 85 years); youngest cases were testicular (23 and 25 years). Solitary lesions were observed in 56 cases (71.7%); multiple lesions were observed in 22 cases (28.2%). Forty-two cases had a white or yellowish color, while 6 cases presented an orange color. CONCLUSION: Primary cancer sites and clinical features of choroidal metastasis in Mexican patients show important differences from other populations previously studied, mainly the presence of a higher proportion of gastrointestinal and renal cancer, as well as higher incidence of ovarian and testicular cancer. These types of cancer, although not as common as breast or lung, need to be taken into account when studying Mexican patients living abroad.
RESUMO
OBJECTIVE: Increased retinal vasopermeability (RVP) occurs early in diabetes and is crucial for the development of sight-threatening proliferative diabetic retinopathy (DR). The hormone prolactin (PRL) is proteolytically processed to vasoinhibins, a family of peptides that inhibit the excessive RVP related to DR. Here, we investigate the circulating levels of PRL in association with DR in men and test whether increased circulating PRL, by serving as a source of ocular vasoinhibins, can reduce the pathological RVP in diabetes. RESEARCH DESIGN AND METHODS: Serum PRL was evaluated in 40 nondiabetic and 181 diabetic men at various stages of DR. Retinal vasoinhibins were measured in rats rendered hyperprolactinemic by placing two anterior pituitary grafts under the kidney capsule and in PRL receptor-null mice. RVP was determined in hyperprolactinemic rats subjected to the intraocular injection of vascular endothelial growth factor (VEGF) or made diabetic with streptozotocin. RESULTS: The circulating levels of PRL increased in diabetes and were higher in diabetic patients without retinopathy than in those with proliferative DR. In rodents, hyperprolactinemia led to vasoinhibin accumulation within the retina; genetic deletion of the PRL receptor prevented this effect, indicating receptor-mediated incorporation of systemic PRL into the eye. Hyperprolactinemia reduced both VEGF-induced and diabetes-induced increase of RVP. This reduction was blocked by bromocriptine, an inhibitor of pituitary PRL secretion, which lowers the levels of circulating PRL and retinal vasoinhibins. CONCLUSIONS: Circulating PRL influences the progression of DR after its intraocular conversion to vasoinhibins. Inducing hyperprolactinemia may represent a novel therapy against DR.
Assuntos
Retinopatia Diabética/prevenção & controle , Prolactina/sangue , Animais , Biomarcadores/sangue , Proteínas de Ciclo Celular/metabolismo , Diabetes Mellitus Experimental/fisiopatologia , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/fisiopatologia , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/fisiopatologia , Retinopatia Diabética/sangue , Retinopatia Diabética/patologia , Humanos , Hiperprolactinemia/sangue , Masculino , Camundongos , Pessoa de Meia-Idade , Ratos , Ratos Wistar , Fator A de Crescimento do Endotélio VascularRESUMO
Retinal pathological angiogenesis is the leading cause of visual loss in a wide variety of ocular diseases. Some of the examples include: Age-related macular degeneration, diabetic retinopathy and retinopathy associated with prematurity. These last two entities are, in addition, public health problems in developing countries. Recent physiopathological studies, have demonstrated that growth factors play a key role on angiogenesis. Anti-angiogenic therapy came about as an attempt to inhibit the action of growth factors over the process of pathological angiogenesis in order to preserve vision. The objective of this review is to describe Mexico's experience using this therapeutic approach.
Assuntos
Inibidores da Angiogênese/uso terapêutico , Neovascularização de Coroide/tratamento farmacológico , Neovascularização Retiniana/tratamento farmacológico , Algoritmos , Anticorpos Monoclonais/uso terapêutico , Anticorpos Monoclonais Humanizados , Bevacizumab , Humanos , MéxicoRESUMO
La angiogénesis patológica retiniana es la causa principal de pérdida visual en una gran cantidad de enfermedades: degeneración macular relacionada a la edad, retinopatía diabética y retinopatía del prematuro, en otras. Estas últimas dos son, además, problemas de salud pública en los países en desarrollo. Estudios recientes sobre la fisiopatología de estas enfermedades han demostrado el papel fundamental que los factores de crecimiento tienen sobre la angiogénesis. La terapia antiangiogénica ocular nació como un esfuerzo de inhibir la acción de estos factores sobre la angiogénesis patológica y preservar la visión. El objetivo de esta revisión es hacer un recuento de la experiencia en México en cuanto a esta modalidad terapéutica.
Retinal pathological angiogenesis is the leading cause of visual loss in a wide variety of ocular diseases. Some of the examples include: Age-related macular degeneration, diabetic retinopathy and retinopathy associated with prematurity. These last two entities are, in addition, public health problems in developing countries. Recent physiopathological studies, have demonstrated that growth factors play a key role on angiogenesis. Anti-angiogenic therapy came about as an attempt to inhibit the action of growth factors over the process of pathological angiogenesis in order to preserve vision. The objective of this review is to describe Mexico's experience using this therapeutic approach.
Assuntos
Humanos , Inibidores da Angiogênese/uso terapêutico , Neovascularização Retiniana/tratamento farmacológico , Neovascularização de Coroide/tratamento farmacológico , Algoritmos , Anticorpos Monoclonais/uso terapêutico , MéxicoAssuntos
Retinopatia Diabética/fisiopatologia , Catarata/complicações , Hipóxia Celular , Retinopatia Diabética/complicações , Retinopatia Diabética/prevenção & controle , Retinopatia Diabética/cirurgia , Endotélio Vascular/efeitos dos fármacos , Endotélio Vascular/fisiopatologia , Humanos , Fotocoagulação a Laser , Implante de Lente Intraocular , Edema Macular/etiologia , Masculino , Pessoa de Meia-Idade , Fragmentos de Peptídeos/sangue , Fragmentos de Peptídeos/farmacologia , Fragmentos de Peptídeos/fisiologia , Facoemulsificação , Prolactina/sangue , Prolactina/farmacologia , Prolactina/fisiologia , Processamento de Proteína Pós-Traducional , Neovascularização Retiniana/etiologia , Neovascularização Retiniana/fisiopatologia , Neovascularização Retiniana/cirurgia , Falha de TratamentoRESUMO
PURPOSE: To evaluate the safety and efficacy of perfluorocarbon-perfused vitrectomy (PCPV) as a novel technique in obtaining a large undiluted vitreous biopsy. DESIGN: Cross-sectional interventional study. METHODS: Patients with undiagnosed posterior uveitis scheduled for vitreous biopsy underwent PCPV. A syringe containing 5 ml of perfluorocarbon liquid (PCL) was connected to the infusion line. Aspiration of the central and superior vitreous was initiated with simultaneous infusion of the PCL. RESULTS: Twenty eyes of 20 patients were included in this study. The mean +/- SD amount of PCL used in each eye was 4.50 +/- 0.69 ml. The volume of vitreous sample obtained in each eye was 2.25 +/- 0.413 ml. No complications occurred. CONCLUSIONS: PCPV is a safe and effective method for obtaining large undiluted vitreous biopsy.