RESUMO
The authors feel that orbital tumor metastases are more common than generally presumed. The occurence of orbital metastases of malignant melanomas of the skin is discussed in this paper. Until now 20 cases have been published. Therapy of metastases is an unsolved problem, immunologic factors might be of some importance. The authoress describes a case of histologically verified orbital metastasis of a primary malignant melanoma of the skin, which was surgical removed three years ago. In contrast to similar cases other haematogen tumor manifestations were absent first, and the orbital metastasis seemed to be totally removed by orbital exenteration. One year later however, probably as a second metastasis, rapidly progressive tumor tissue appeared. General melanomatosis having appeared at the same time finally lead to death.
Assuntos
Melanoma/diagnóstico , Neoplasias Orbitárias/diagnóstico , Adulto , Humanos , Masculino , Melanoma/epidemiologia , Melanoma/cirurgia , Metástase Neoplásica , Neoplasias Orbitárias/epidemiologia , Neoplasias Orbitárias/cirurgia , Neoplasias Cutâneas/epidemiologia , Fatores de Tempo , UltrassonografiaRESUMO
In agreement with other clinical reports we observed in 20 patients that Parinaud's syndrome may be associated with other midbrain symptoms. Most frequently we found convergence insufficiency or pupillary changes. In contrast to textbooks in most cases that was an incomplete, absolute paralysis of pupillary constriction. Some patients had also paresis of the 3rd and 4th cranial nerve or lesions of the medial longitudinal fasciculus (internuclear ophthalmoplegia). All clinical patterns which we noted were understandable in view of the topographical relationship of their presumed lesions. However, none of the symptoms was invariably associated with Parinaud's syndrome.
Assuntos
Oftalmoplegia/diagnóstico , Reflexo Pupilar , Tronco Encefálico/irrigação sanguínea , Diplopia/diagnóstico , Humanos , Isquemia/complicações , Nistagmo Patológico/diagnóstico , Oftalmoplegia/etiologia , SíndromeRESUMO
In most cases of congenital lacrimal fistulae occuring in the ophthalmic literature the condition is diagnosed only during later life. Then, however, the congenital nature is doubtful. This paper describes a new-born with bilateral congenital lacrimal fistulae. Furthermore, the underfed patient has heart and genital malformations. The indication for surgical management of congenital lacrimal fistulae is discussed.