RESUMO
Cystic lesions of the eyelids are not uncommon and are variable in nature. A case report of a 42-year-old male patient is detailed. A bilateral cystic lesion was clearly visible at both medial canthuses. Surgical resection was performed under local anesthesia, followed by histopathological study of the specimens. This revealed that these lesions were hidrocystomas, of probable eccrine origin. As many different cystic lesions may be encountered on the eyelids (dermoid cysts, epidermic cysts, cystic basal cell carcinomas...), routine histopathological study of surgically removed cystic specimens is mandatory to obtain an accurate diagnosis.
Assuntos
Neoplasias das Glândulas Sudoríparas/patologia , Adulto , Olho , Humanos , Masculino , Neoplasias das Glândulas Sudoríparas/cirurgiaRESUMO
Pigmented tumors of the eyelid are often difficult to identify accurately, as different tumors may have the same clinical presentation. We report the case of a 84 year old female patient who noticed a black tumor of the lower eyelid, with a recent increase in size. Clinically, this lesion was an exophytic tumor of the medial part of the left lower eyelid, respecting the lacrimal punctum and involving the palpebral margin. A surgical excision was performed. Microscopic examination revealed a pigmented seborrheic keratosis, a benign tumor of the epidermis. Histopathology has a key role in the precise diagnosis of pigmented tumors of the eyelid, in which the differential diagnosis concludes sweat gland cysts, pigmented basal cell carcinoma, naevus and uncommon malignant melanoma.
Assuntos
Doenças Palpebrais/patologia , Pigmentação da Pele , Verrugas/patologia , Idoso , Idoso de 80 Anos ou mais , Feminino , HumanosRESUMO
The limbus is an elective site of epithelial malignancies, mostly represented by precarcinomatous lesions. An 83-year-old female patient was operated for an exophytic tumor of the limbus. Histological examination showed an invasive squamous carcinoma. As the excision was not complete, complementary radiation therapy (45 Gy) was applied with a good short-term result. This case report emphasizes the value of early diagnosis and treatment of limbal tumors at the stage of precancerous lesions.
Assuntos
Carcinoma de Células Escamosas/patologia , Neoplasias da Túnica Conjuntiva/patologia , Limbo da Córnea , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Invasividade NeoplásicaRESUMO
Keratinised tumors of the conjunctiva are not uncommon lesions. However, different pathological lesions may have a similar clinical. Actinic keratosis is one of these, it is an epithelial pre-cancerous lesion of the conjunctiva, which may become, if untreated, an invasive carcinoma. A case of bilateral lesions of this type is reported in a 61-year-old male patient who used to work outdoors, and the clinical diagnosis was followed by bilateral surgical removal of the two lesions. Histological examination study showed that the acquired modifications of the epithelium were typical of conjunctival actinic keratosis.
Assuntos
Neoplasias da Túnica Conjuntiva/patologia , Ceratose/patologia , Limbo da Córnea/patologia , Lesões Pré-Cancerosas/patologia , Raios Ultravioleta , Epitélio/patologia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Primary adnexal tumors of the eyelids are quite uncommon. This diagnosis should be considered in the case of a sub-epidermal tumor. We report the case of a 25-year-old female patient presenting with a left eyelid nodular tumor, which appeared clinically as a whitish swelling of the lateral part of the eyelid, covered by normal epidermis. Ultrasonography showed a heterogeneous structure probably containing calcified areas. Complete surgical removal was performed under local anesthesia. Macroscopically, the tumor was encapsulated, with an irregular surface, and it appeared stony under section. Microscopically, it was characteristic of a pilomatrixoma, with sheets of mummified cells devoid of nuclei, either clear or basophilic, and partially calcified. Neither granulomatous reaction nor ossification were observed. This clinicopathological report recalls that pilomatrixoma may appear as a single nodular tumor of the eyelid.
Assuntos
Neoplasias Palpebrais/patologia , Neoplasias Cutâneas/patologia , Adulto , Calcinose/patologia , Calcinose/cirurgia , Neoplasias Palpebrais/cirurgia , Feminino , Humanos , Neoplasias Cutâneas/cirurgiaRESUMO
The authors report on the diagnosis and treatment of a rare and benign orbital tumor (cholesterol granuloma) in a 40 year-old man. They separate, clinically and histologically, cholesterol granuloma from epidermoid cholesteatoma.
Assuntos
Colesteatoma/patologia , Granuloma/patologia , Doenças Orbitárias/patologia , Adulto , Colesteatoma/diagnóstico , Colesterol , Diagnóstico Diferencial , Granuloma/diagnóstico , Humanos , Masculino , Doenças Orbitárias/diagnósticoRESUMO
Four years after unexplained left eye visual loss and 15 days after surgical procedure on the other eye, a 93-year-old female developed a pigmented left conjunctival lesion. Ultrasound examination demonstrated this lesion to be in fact an extraocular extension of uveal melanoma. The patient was treated by external radiotherapy after expanded enucleation.
Assuntos
Neoplasias da Túnica Conjuntiva/diagnóstico , Melanoma/diagnóstico , Neoplasias Uveais/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Coroide/diagnóstico , Corpo Ciliar , Diagnóstico Diferencial , Feminino , HumanosRESUMO
Conjunctival cystic lesions are not uncommon and may arise anywhere in the conjunctiva, although the inferior fornix is one of the most frequent sites. We report the case of a 5 year-old-male black patient who underwent surgical excision of an unusually large conjunctival cyst of the inferior left fornix. The histopathological study showed that the cyst border was lined by a conjunctival epithelium, consistent with a conjunctival inclusion cyst.
Assuntos
Doenças da Túnica Conjuntiva/patologia , Cistos/patologia , Pré-Escolar , Neoplasias da Túnica Conjuntiva/patologia , Humanos , MasculinoRESUMO
Posterior lens dislocations represent 20 to 40% of all lens dislocations. It can occur after trauma. Visual prognosis can be good, but most often there are complications such as glaucoma, retinal detachment and uveitis. A few years ago, surgery was difficult, and surgery was delayed until the development of specific complications. A new technique, using perfluorocarbon liquids (PFCL), should be recommended because it is simple, and constantly effective. After vitrectomy, perfluorodecalin is injected into the vitreous cavity. As PFCL have a density twice the density of water, it allows the lens to float on the surface of the PFCL, behind the iris. Lens extraction can be associated with trabeculectomy, and anterior chamber lens implantation. We present a prospective study of 6 cases operated according to this technique. Postoperative results were good: visual acuity was preserved and ocular tension was controlled in cases of preoperative hypertonia. We believe this technique can be recommended after posterior lens dislocation, to prevent complications and to preserve visual acuity.
Assuntos
Fluorocarbonos/uso terapêutico , Subluxação do Cristalino/cirurgia , Idoso , Traumatismos Oculares/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Tempo , VitrectomiaRESUMO
The clinico-pathological findings in a 45-year-old male patient with a lacrimal gland tumor are reported. This tumor had a spontaneous course of about nine years before it was resected. The clinical presentation was unusual as the tumor appeared as a nodular well-circumscribed swelling of the lateral part of the left superior eyelid. Imaging techniques did not reveal any involvement of the orbital part of the lacrimal gland. However a wide supero-lateral approach was chosen to achieve monobloc resection. Histopathology showed the typical features of an encapsulated pleomorphic adenoma, with no suspicious cytologic changes. Complete resection had a total curative effect for the patient. A wide lateral approach seems to be mandatory for tumors of the lacrimal gland to avoid partial resection and local recurrences.
Assuntos
Neoplasias Palpebrais/patologia , Doenças do Aparelho Lacrimal/patologia , Neoplasias Embrionárias de Células Germinativas/patologia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
A case of Meibomian carcinoma of the left eyelid was observed in a 53-year-old-female patient. SHe had been previously treated for chronic unilateral blepharoconjunctivitis; an excisional biopsy disclosed a Meibomian carcinoma. First a total resection of both left eyelids was performed with plastic reconstructive surgery, three months later a recurrence required an orbital exenteration. This case underlines the interest of an early diagnosis which allows a more conservative treatment. The diagnosis must be kept in mind in any case of chronic unilateral blepharoconjunctivitis; histopathology has a key role in the diagnosis of Meibomian carcinoma.
Assuntos
Adenocarcinoma/patologia , Neoplasias da Túnica Conjuntiva/patologia , Neoplasias Palpebrais/patologia , Adenocarcinoma/cirurgia , Neoplasias da Túnica Conjuntiva/cirurgia , Neoplasias Palpebrais/cirurgia , Feminino , Humanos , Metástase Linfática , Glândulas Tarsais , Pessoa de Meia-Idade , Invasividade NeoplásicaRESUMO
A malignant ciliary body melanoma was treated by proton-beam irradiation. Ring-shaped recurrence with extraocular extension appeared thirty-six months later and required enucleation. Histologic study revealed a predominant epithelioid cell type tumor, flattened in previously treated area. Proton-beam irradiation efficiency depends on clinical evaluation, which remains questioned in ciliary body locations where circumferential extension could be misevaluated.
Assuntos
Corpo Ciliar , Melanoma/radioterapia , Recidiva Local de Neoplasia , Prótons , Neoplasias Uveais/radioterapia , Idoso , Feminino , Humanos , Fatores de TempoRESUMO
A 28-year-old male patient had a chalazion on his left eyelid. Increased discomfort led to the discovery of a conjunctival mass under the inner part of his upper eyelid. On clinical examination, a small reddish mass on the palpebral conjunctiva of the upper left eyelid was only visible on the underside of the lid; the mass was diffusely reddish. Additionally, a chalazion was present in the middle of the lower left eyelid. As this condition was a source of discomfort to the patient, the mass was surgically resected. The histological study found a typical pyogenic granuloma, a possible complication in the course of a chalazion.
Assuntos
Calázio/complicações , Doenças da Túnica Conjuntiva/etiologia , Doenças Palpebrais/etiologia , Granuloma Piogênico/etiologia , Adulto , Doenças Palpebrais/patologia , Granuloma Piogênico/patologia , Humanos , MasculinoRESUMO
Most conjunctival nevi are found during the two first decades of life. Beyond this period, the diagnosis must be assessed by histopathology. We report the case of a conjunctival nevus recently discovered in a 33-year-old patient who, additionally, was previously treated for herpetic disciform keratitis. The corneal scar decreased vision. A corneal graft and nevus excision were performed simultaneously. Histopathologic study confirmed the diagnosis of nevus and disclosed the corneal scar changes induced by herpes.
Assuntos
Neoplasias da Túnica Conjuntiva/patologia , Ceratite Herpética/patologia , Adulto , Cicatriz/patologia , Córnea/patologia , Transplante de Córnea/patologia , Diagnóstico Diferencial , Humanos , Masculino , Acuidade Visual/fisiologiaRESUMO
A clinico-pathologic case of a black hidrocystoma of the left eyelid margin is reported in a 45-year-old female patient. Clinically, a black nodule was disclosed after eversion of the superior left lid. A surgical full thickness eyelid focal resection was performed to remove the cyst. Histopathology found a cyst covered with an epithelium with a double layer of cells and filled with a brownish granular content, typical of a black hidrocystoma.
Assuntos
Neoplasias Palpebrais/diagnóstico , Hidrocistoma/diagnóstico , Neoplasias das Glândulas Sudoríparas/diagnóstico , Grânulos Citoplasmáticos/ultraestrutura , Epitélio/patologia , Neoplasias Palpebrais/patologia , Neoplasias Palpebrais/cirurgia , Feminino , Hidrocistoma/patologia , Hidrocistoma/cirurgia , Humanos , Pessoa de Meia-Idade , Pigmentação , Neoplasias das Glândulas Sudoríparas/patologia , Neoplasias das Glândulas Sudoríparas/cirurgiaRESUMO
Cavernous hemangioma is one of the commonest primary orbital tumors. Painless and progressive reducible unilateral proptosis causing a variable degree of hyperopia is the usual clinical presentation. The case of a 39-year-old-female patient is reported. The clinical presentation was unilateral left axial proptosis with acquired hyperopia. Imaging studies showed a well circumscribed mass in the orbit, a superior neuro-surgical approach allowed complete resection of the tumor, and histopathology revealed the diagnosis of cavernous hemangioma.
Assuntos
Hemangioma Cavernoso/patologia , Neoplasias Orbitárias/patologia , Adulto , Feminino , Hemangioma Cavernoso/diagnóstico , Humanos , Neoplasias Orbitárias/diagnósticoRESUMO
The clinicopathologic case of a 69-year-old-female patient with a big caruncular melanoma is reported. Tumor was excised surgically and underwent external conventional radiation therapy with no recurrence two years later. Histopathology endorsed the clinical diagnosis and thickness of the tumor measured 5.5 mm. The bad prognosis of the caruncular location was reinforced by the tumor thickness. A better knowledge of conjunctival melanomas characteristics might allow an earlier diagnosis and a better prognosis as irradiation following surgical treatment appears efficient on unifocal limited melanomas.
Assuntos
Neoplasias da Túnica Conjuntiva/diagnóstico , Melanoma/diagnóstico , Idoso , Neoplasias da Túnica Conjuntiva/patologia , Neoplasias da Túnica Conjuntiva/cirurgia , Feminino , Seguimentos , Humanos , Melanoma/patologia , Melanoma/cirurgia , PrognósticoRESUMO
A clinico-pathologic case of a 83-year-old female patient with a deeply pigmented inferior lid tumor is reported. The histopathological study of the tumor demonstrated a pigmented basal cell carcinoma. Numerous different tumors may affect the eyelids, melanocytic or not in nature. True melanomas are infrequent compared with the numerous other pigmented tumors, which always need a histological analysis.
Assuntos
Carcinoma Basocelular/diagnóstico , Neoplasias Palpebrais/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Carcinoma Basocelular/patologia , Carcinoma Basocelular/cirurgia , Neoplasias Palpebrais/patologia , Neoplasias Palpebrais/cirurgia , Feminino , HumanosRESUMO
A primary acquired melanosis occurred in the right bulbar conjunctiva of a 65 year-old caucasian woman. After four years of steadiness, this lesion gave raise to a malignant conjunctival melanoma. The evolution remained under control three years after the end of the therapeutic procedures. Clinical and histopathological data are presented.
Assuntos
Doenças da Túnica Conjuntiva/patologia , Neoplasias da Túnica Conjuntiva/patologia , Melanoma/patologia , Melanose/patologia , Idoso , Biópsia , Túnica Conjuntiva/patologia , Neoplasias da Túnica Conjuntiva/cirurgia , Feminino , Seguimentos , Humanos , Melanoma/cirurgia , Reoperação , Fatores de TempoRESUMO
A 3-year-old girl had a tumor growing for a month on the superior right eyelid, attached on the free margin of the eyelid and partially necrotic. A surgical excision was performed under general anesthesia. The histopathological study found an inflammatory lesion with epithelioid and giant cells, evidence of a granuloma, suggesting the diagnosis of chalazion. This case shows the various clinical presentations of this common and benign disease of the eyelid.