Correlación clínica y anatomopatológica de los tumores palpebrales intervenidos quirúrgicamente en el Servicio de Oculoplastia / Clinical and anatomopathological correlation of palpebral tumors operated on at the Oculoplasty Service

Objetivo: caracterizar la correlación clínica y anatomopatológica de las lesiones tumorales palpebrales. Métodos: se realizó un estudio descriptivo y retrospectivo en los pacientes con tumores palpebrales intervenidos quirúrgicamente en el Servicio de Cirugía Plástica Ocular del Instituto Cubano de Oftalmología Ramón Pando Ferrer en el período de enero a septiembre de 2011. La muestra quedó constituida por 196 pacientes operados de las diferentes tumoraciones palpebrales, quienes cumplieron con los criterios de inclusión. Las variables que se utilizaron fueron: edad, sexo, color de la piel, localización de los tumores palpebrales malignos, calidad de la exéresis quirúrgica y correspondencia entre el diagnóstico clínico y el anatomopatológico. Resultados: el grupo de edad de mayor porcentaje fue el de 65 años y más, con 38 porciento, así como el sexo femenino con 63 porciento. Fue mayor el número de pacientes de piel blanca, con 85 porciento. Coexistió correspondencia clínica y anatomopatológica en el 65 por ciento de los casos con tumoracionesbenignas, y en las malignas con el 71 por ciento. En la mayoría de los casos la exéresis de la lesión fue completa. Conclusiones: existe correspondencia entre el diagnóstico clínico y el anatomopatológico de las tumoraciones palpebrales, la cual es superior en los tumores malignos(AU)

Objective: to characterize the clinical and pathological correlation of eyelid tumor lesions. Methods: a retrospective and descriptive study was conducted in patients with eyelid tumors surgically treated at the Ocular Plastic Surgery Department of Ramón Pando Ferrer Cuban Institute of Ophthalmology in the period from January to September 2011. The sample consisted of 196 patients operated on from different eyelid tumors , who met the inclusion criteria. The variables used were age, sex, race, location of malignant eyelid tumors, quality of the surgical resection quality and correspondence between the clinical and the pathological diagnoses. Results: the largest age group was the 65 years-old percent and older with 38 percent, and females accounted for 63 percent. The Caucasian patients represented 85percent. There was clinical and pathological correspondence in 65 percent of patients with benign tumors and in 71 percent of malignancies. Excision of the lesion was complete in most of cases. Conclusions: there was correspondence between the clinical and the pathological diagnoses of eyelid tumors, being higher in malignant tumors.(AU)

Correlación clínica y anatomopatológica de los tumores palpebrales intervenidos quirúrgicamente en el servicio de oculoplastia / Clinical and anatomopathological correlation of palpebral tumors operated on at the oculoplasty service

OBJETIVO: caracterizar la correlación clínica y anatomopatológica de las lesiones tumorales palpebrales. MÉTODOS: se realizó un estudio descriptivo y retrospectivo en los pacientes con tumores palpebrales intervenidos quirúrgicamente en el Servicio de Cirugía Plástica Ocular del Instituto Cubano de Oftalmología "Ramón Pando Ferrer" en el período de enero a septiembre de 2011. La muestra quedó constituida por 196 pacientes operados de las diferentes tumoraciones palpebrales, quienes cumplieron con los criterios de inclusión. Las variables que se utilizaron fueron: edad, sexo, color de la piel, localización de los tumores palpebrales malignos, calidad de la exéresis quirúrgica y correspondencia entre el diagnóstico clínico y el anatomopatológico. RESULTADOS: el grupo de edad de mayor porcentaje fue el de 65 años y más, con 38 %, así como el sexo femenino con 63 %. Fue mayor el número de pacientes de piel blanca, con 85 %. Coexistió correspondencia clínica y anatomopatológica en el 65 % de los casos con tumoraciones benignas, y en las malignas con el 71 %. En la mayoría de los casos la exéresis de la lesión fue completa. CONCLUSIONES: existe correspondencia entre el diagnóstico clínico y el anatomopatológico de las tumoraciones palpebrales, la cual es superior en los tumores malignos.

OBJECTIVE: to characterize the clinical and pathological correlation of eyelid tumor lesions. METHODS: a retrospective and descriptive study was conducted in patients with eyelid tumors surgically treated at the Ocular Plastic Surgery Department of "Ramón Pando Ferrer" Cuban Institute of Ophthalmology in the period from January to September 2011. The sample consisted of 196 patients operated on from different eyelid tumors , who met the inclusion criteria. The variables used were age, sex, race, location of malignant eyelid tumors, quality of the surgical resection quality and correspondence between the clinical and the pathological diagnoses. RESULTS: the largest age group was the 65 years-old percent and older with 38 %, and females accounted for 63 %. The Caucasian patients represented 85%. There was clinical and pathological correspondence in 65 % of patients with benign tumors and in 71 % of malignancies. Excision of the lesion was complete in most of cases. CONCLUSIONS: there was correspondence between the clinical and the pathological diagnoses of eyelid tumors, being higher in malignant tumors.

[Management of eyelid tumors: general considerations]. / Prise en charge des tumeurs palpébrales : considérations générales.

Despite the fact that the majority of eyelid tumors are benign, proper management in daily practice requires detection of the malignant ones. Several clinical criteria are usually proposed to support or reject a hypothesis of malignancy; however, most are of limited reliability. In any case of doubt, outpatient biopsy is recommended, so as to establish the correct diagnosis and formulate the most appropriate treatment plan. In all facial malignancies, the first (and absolutely mandatory) consideration is control of the cancer. Then, restoration of eyelid function can be addressed, in the following order: protection of the globe by complete dynamic eyelid closure and opening, visual function (and prevention of possible deprivation amblyopia) by insuring a clear visual axis, correction of the tear film, efficient lachrymal drainage, and only then the role of the eyelids in facial expression and esthetics. For most malignant eyelid tumors, the best assurance of complete excision is obtained by extemporaneous examination of the resection margins by frozen section (by Mohs' micrographic surgery techniques, or a variation thereof). Currently, advancement and transposition flaps, possibly in combination with tarso-conjunctival or skin grafts, are the most utilised techniques. Despite the lack of histological verification, new treatment modalities, including topical chemotherapy, photodynamic therapy and cryotherapy, may provide interesting treatment options, particularly in collaboration with the dermatologist.

Treatment of superficial infantile hemangiomas of the eyelid using the 595-nm pulsed dye laser.

BACKGROUND: Despite the proven effectiveness of the 595-nm pulsed dye laser (PDL) in treating superficial infantile hemangiomas, many physicians are reluctant to treat such lesions involving the eyelid. OBJECTIVE To examine the safety and efficacy of the 595-nm PDL for the treatment of superficial infantile hemangiomas of the eyelid. MATERIALS & METHODS: Records were reviewed for patients with superficial infantile hemangiomas of the eyelid treated with 595-nm PDL. Pre- and post-treatment photographs were compared. Reviewers rated the degree of improvement of the hemangioma as excellent (76-100%), good (51-75%), moderate (26-50%), or poor (0-25%) and indicated whether the hemangioma was 100% clear. Side effects of scarring, atrophy, hyperpigmentation, and hypopigmentation were assessed. RESULTS: Twenty-two patients met the study criteria. Eight (36.4%) demonstrated complete clearance of their hemangioma, 17 (77.3%) received an improvement rating of excellent, and five (22.7%) received a rating of good. No scarring, atrophy, or hypopigmentation was noted. Two patients (9.1%) were noted to have hyperpigmentation in the treated area. CONCLUSION: Early treatment with the 595-nm PDL can safely and effectively diminish proliferative growth and hasten resolution of superficial infantile hemangiomas of the eyelid.

[Cystic adenocarcinomas of the lacrymal gland]. / Les adénocarcinomes kystiques de la glande lacrymale.

UNLABELLED: Adenoid cystic carcinoma of the lacrimal gland. BACKGROUND: Adenoid cystic carcinoma is the most frequent epithelial tumour of the lacrimal gland. It represents 1.6 % of the orbital tumours. The aim of this study is to present a series of such patients who were followed up in our clinic and to discuss their clinical management in order to achieve a better life prognosis. MATERIALS AND METHODS: The cases we followed up in our department were presented, the treatment modalities were discussed, and conclusions were drawn. RESULTS: Six patients with this pathology were examined, 3 men and 3 women, aged 31 to 69 years. A large excision was performed in 5 patients (exenteration alone or extended exenteration with complementary radiotherapy) and in 1 patient with excision of the tumour followed by radiotherapy. One patient died due to carcinoma six years after the first surgery. The median follow-up period of our cases is 25 months. CONCLUSION: Adenoid cystic carcinoma of the lacrimal gland is a malignant tumour with a reserved prognosis. Various treatments were proposed to improve the mortality rate of the disease. At present radical surgery with or without complementary therapy seems to give the best chances of healing, at least with short or mid-term follow-up.

Intra-epidermal carcinoma of the eyelid margin.

Twenty-two cases of intra-epidermal carcinoma of the ciliary margin have been diagnosed in a 15-year survey. The clinical appearance is variable, resembling in some instances a benign warty lesion, and in others a fully developed squamous cell carcinoma. As the lesion grows it produces keratotic plugging of the lash follicles and nodules on the lid margin; in due course this results in loss of the related cilia. When dermal invasion occurs the resultant squamous cell carcinoma is potentially dangerous because of the involvement of the adnexal structures, which on the ciliary margins are particularly large and penetrate deeply into the lid substance. Adequate biopsy which includes at least one lash follicle is essential for accurate diagnosis, and treatment requires complete excision with a reasonable margin for safety. Of the twenty-two patients, nineteen were male and three female; fourteen of the men involved had handled oils and greases for prolonged periods.