Leiomioma orbitario gigante en un paciente pediátrico: reto diagnóstico y terapéutico / Giant orbital leiomyoma in a pediatric patient: Diagnostic and therapeutic challenge

Este manuscrito presenta un caso de un leiomioma orbitario de larga evolución en un joven de 14años. El tumor era inusualmente grande y causaba una proptosis severa y una afectación importante de la musculatura ocular. El paciente presentaba amaurosis, una oftalmoplejía completa, dolor ocular espontáneo e incapacidad para cerrar los párpados. Debido al tamaño del tumor y a su progresión, se realizó una exenteración orbitaria derecha para eliminar todo el contenido orbitario, incluyendo el tumor y el globo ocular. El procedimiento quirúrgico tenía como objetivo prevenir la recurrencia del tumor y mejorar la calidad de vida del paciente. El análisis histopatológico confirmó el diagnóstico de leiomioma orbitario. Este caso presenta un interés particular por el grado de evolución que ha alcanzado. La extirpación completa del tumor y un seguimiento a largo plazo son necesarios para prevenir la recurrencia y garantizar resultados óptimos para el paciente. Además, este caso refleja las grandes diferencias en el acceso a la sanidad en las diferentes regiones del mundo. (AU)

This manuscript describes an exceptional case of a long-standing orbital leiomyoma in a 14-year-old male. The tumor was unusually large, causing severe proptosis and significant involvement of the ocular muscles. The patient presented with amaurosis, complete ophthalmoplegia, spontaneous eye pain, and the inability to close the eyelids, leading to psychological distress. Due to the tumor's size and progression, a right orbital exenteration was performed to remove all orbital contents, including the tumor and the eyeball. The surgical procedure aimed to prevent tumor recurrence and improve the patient's quality of life. The histopathological analysis confirmed the diagnosis of orbital leiomyoma. This case presents a particular interest due to the degree of evolution it has reached. Complete tumor excision and long-term follow-up are necessary to prevent recurrence and ensure optimal patient outcomes. This report underscores global healthcare disparities and the complexity of managing rare orbital neoplasms in diverse country settings. (AU)

Giant orbital leiomyoma in a pediatric patient: diagnostic and therapeutic challenge.

This manuscript describes an exceptional case of a long-standing orbital leiomyoma in a 14-year-old male. The tumor was unusually large, causing severe proptosis and significant involvement of the ocular muscles. The patient presented with amaurosis, complete ophthalmoplegia, spontaneous eye pain, and the inability to close the eyelids, leading to psychological distress. Due to the tumor's size and progression, a right orbital exenteration was performed to remove all orbital contents, including the tumor and the eyeball. The surgical procedure aimed to prevent tumor recurrence and improve the patient's quality of life. The histopathological analysis confirmed the diagnosis of orbital leiomyoma. This case presents a particular interest due to the degree of evolution it has reached. Complete tumor excision and long-term follow-up are necessary to prevent recurrence and ensure optimal patient outcomes. This report underscores global healthcare disparities and the complexity of managing rare orbital neoplasms in diverse country settings.

[Lacrimal duct obstruction treated with lacrimonasal stent]. / Obstrucción de vía lagrimal tratada mediante stent lacrimonasal.

OBJECTIVE: To analyze a series of patients with lacrimal duct obstruction treated with polyurethane stents. MATERIAL AND METHODS: We studied 125 cases of lacrimal duct obstruction corresponding to 115 patients, of whom 30 were males (26.08%) and 85 females (73.91%). The obstruction involved the right side in 51 cases (40.8%) and the left side in 74 (59.2%). Mean age was 65 +/- 14.64 years. Symptoms included chronic epiphora in 65 patients (52%), acute lacrimal sac inflammation in 33 (26.4%), mucocele in 6 (4.8%) and recurrent conjunctivitis in 4 (3.2%). Seventeen patients came to us diagnosed with lacrimal duct obstruction. Time of follow up was one year. RESULTS: Stents were successfully implanted in 120 cases (96%). Surgical complications included pain in 5.83%, eyelid inflammation in 5%, nasal bleeding in 0.83% and false duct in 0.83%. Functional success was achieved in 82 patients (68.3%), and surgical failure occurred in 38 patients (31.7%). Mean time of stent failure was 178 days. In these cases, inner granulation tissue was found in 63.15% of the cases and mucoid material in 36.85%. The most common postoperative complication was mucocele formation, which ocurred in 7.5% of the patients. CONCLUSIONS: In our experience, polyurethane stent implantation is a good alternative for treating nasolacrimal obstruction, but not as effective as endonasal or external dacryocystorhinostomy.

Obstrucción de vía lagrimal tratada mediante stent lacrimonasal / Lacrimal duct obstruction treated with lacrimonasal stent

Objetivo: Analizar los resultados de la implantación de stents lacrimonasales de poliuretano y las características de los pacientes y las intervenciones realizadas. Material y métodos: Estudio de 125 casos de obstrucción del conducto lacrimonasal en 115 pacientes, 30 varones y 85 mujeres. Obstrucciones del lado derecho 51 (40,8 por ciento) y del lado izquierdo 74 (59,2 por ciento). Edad media de los enfermos: 65 DE 14,61 años. La clínica de los pacientes fue epífora 65 casos (52 por ciento), dacriocistitis aguda 33 (26,4 por ciento), mucocele 6 (4,8 por ciento), conjuntivitis de repetición 4 casos (3,2 por ciento). Un total de 17 pacientes nos fueron remitidos con el diagnóstico de obstrucción de vía lagrimal. El tiempo de seguimiento fue de 1 año. Resultados: Implante realizado con éxito en 120 casos (96 por ciento). Las complicaciones intraoperatorias más importantes fueron dolor 5,83 por ciento, inflamación palpebral 5 por ciento, falsa vía y epistaxis, 0,83 por ciento cada una. La epífora desapareció en 82 casos (68,3 por ciento) y persistió en 38 (31,7 por ciento). Tiempo medio de fallo del stent en este último grupo 178 días. En los stents que fallaron se encontró tejido de granulación en un 63,15 por ciento y material mucoide en 36,85 por ciento. La principal complicación postoperatoria fue mucocele en el 7,5 por ciento de los casos. Conclusiones: Consideramos esta técnica una buena alternativa para el tratamiento de la obstrucción de la vía lagrimal, aunque sin alcanzar los resultados de la dacriocistorrinostomía externa o endonasal (AU)

Objective: To analyze a series of patients with lacrimal duct obstruction treated with polyurethane stents. Material and Methods: We studied 125 cases of lacrimal duct obstruction corresponding to 115 patients, of whom 30 were males (26.08%) and 85 females (73.91%). The obstruction involved the right side in 51 cases (40.8%) and the left side in 74 (59.2%). Mean age was 65 ± 14.64 years. Symptoms included chronic epiphora in 65 patients (52%), acute lacrimal sac inflammation in 33 (26.4%), mucocele in 6 (4.8%) and recurrent conjunctivitis in 4 (3.2%). Seventeen patients came to us diagnosed with lacrimal duct obstruction. Time of follow up was one year. Results: Stents were successfully implanted in 120 cases (96%). Surgical complications included pain in 5.83%, eyelid inflammation in 5%, nasal bleeding in 0.83% and false duct in 0.83%. Functional success was achieved in 82 patients (68.3%), and surgical failure occurred in 38 patients (31.7%). Mean time of stent failure was 178 days. In these cases, inner granulation tissue was found in 63.15% of the cases and mucoid material in 36.85%. The most common postoperative complication was mucocele formation, which ocurred in 7.5% of the patients. Conclusions: In our experience, polyurethane stent implantation is a good alternative for treating nasolacrimal obstruction, but not as effective as endonasal or external dacryocystorhinostomy (AU)

Diclofenac sódico versus dexametasona en el pretratamiento de la trabeculoplastía con láser de argón / Diclofenac sodium vs dexametasone therapy before argon laser trabeculoplasty

Realizamos un estudio prospectivo, randomizado y doble ciego en 40 pacientes, para comparar la influencia que la administración tópica de un nuevo inhibidor de la síntesis de prostaglandinas -el diclofenac sódico al 0,1%- podría tener en el curso postoperatorio de ojos con glaucoma de ángulo abierto que fueron sometidos a una trabeculoplastia con láser de argón. No hallamos diferencias estadísticamente significativas entre los dos grupos en cuanto al incremento inmediato de la presión intraocular y la respuesta inflamatoria postoperatoria que siguieron a la laserterapia. Sin embargo, pensamos que el colirio de diclofenac sódico al 0,1% es útil como agente antiinflamatorio tópico después de la trabeculoplastia, por carecer de los efectos secundarios de los corticosteroides