Photodynamic therapy using methyl aminolevulinate acid in eyelid basal cell carcinoma: a 5-year follow-up study.

PURPOSE: To evaluate retrospectively the long-term results of methyl aminolevulinate photodynamic therapy for the treatment of eyelid basal cell carcinoma. METHODS: Sixteen consecutive patients with eyelid basal cell carcinoma were treated with methyl aminolevulinate photodynamic therapy between January 2002 and April 2003. Selection criteria were tumors located at least 3 mm from the tarsus, surgery not indicated because of poor general health, and recurrences with unclear location definition. Patients were treated with an 80-J cm light-emitting diode light source (632 nm) after topical application of methyl aminolevulinate cream and occlusion for 4 hours. Data were available for follow-up at day 1, week 1, month 1, and every 6 months for 5 years. RESULTS: The mean number of photodynamic therapy session per patient was 3.1 (range, 2-6) Complete clinical recovery was observed after the 5-year follow-up in 13 of 16 patients (82%). Two patients did not respond at all to treatment and 1 patient presented with recurrence after 3 years of tumor-free follow-up. Tolerance of treatment was good with few side effects. CONCLUSIONS: The absence of complications, good tolerance, and a notable success rate make this nonsurgical procedure promising for the treatment of basal cell carcinoma of the eyelid in selected patients.

Orbital solitary fibrous tumor: a case report and review of the literature.

Solitary fibrous tumor (SFT) is a rare spindle cell neoplasm typically arising in the pleura and involving the orbit as its most common extra-pleural location. We herein describe a well documented case of orbital SFT arising in a 62-year-old woman presenting with progressive swelling of the right upper eyelid and proptosis. The tumor had a benign clinical course, with radical surgical excision followed by regression of the clinical symptoms. We review the clinical, histopathological, and immunohistochemical features of the orbital SFT described so far, with particular emphasis on differential diagnosis with other spindle cell orbital neoplasms.

Variable expressivity of abca4 gene mutations in an italian family with stargardt disease.

PURPOSE: Stargardt disease is a juvenile-onset macular dystrophy that can be inherited in an autosomal recessive manner. The gene responsible for the disease is ABCR, which encodes for a retinal protein. The authors report an Italian family with a variable expressivity of ABCR gene mutations. METHOD: Case series. RESULTS: ABCR mutations in both alleles were detected in two affected patients and in three of their healthy relatives. In this family two brothers presented a typical clinical picture of Stargardt disease while the third sister did not have any visual symptom and did not show any fundus abnormalities. Both parents seemed unaffected. CONCLUSIONS: This is an unusual condition that gives rise to a host of molecular genetics speculations.

Rituximab and chlorambucil as first-line treatment for low-grade ocular adnexal lymphomas.

Ocular adnexal lymphomas (OALs) are typically low-grade lymphomas and are largely represented by marginal-zone lymphomas (EMZL). Radiotherapy is the treatment of choice but is frequently associated to local complications. We investigated the association of chlorambucil and rituximab as first-line treatment for primary OALs. Nine consecutive, newly diagnosed OALs patients (eight with a EMZL, one with a follicular lymphoma) with a median age of 78 years were treated with this combination. Eight patients were in stage I-A, and one was in stage IV-A; all patients had low LDH values. Eight patients (89%) obtained a complete remission and one a partial response. All completed the treatment without significant toxicities. After a median follow up of 25 months, all patients are alive; no progressions or late toxicities were observed. Rituximab in combination with chlorambucil proved to be a feasible option as first-line treatment for OALs because of its feasibility and the absence of toxicity and local sequelae.