RESUMEN
Perivascular epithelioid cell tumors comprise a rare and recently described family of neoplasms that characteristically coexpress melanocytic and myoid markers. We describe the clinicopathologic features of 2 ocular cases. Case 1 occurred in a 26-year-old woman with a recurrent left upper eyelid tumor, and case 2 was diagnosed in a 7-year-old boy with a left ciliary body mass. This is the first report of perivascular epithelioid cell tumor arising in the ciliary body or eyelid. Neither patient in our series had documented evidence of the tuberous sclerosis complex. Despite its rarity, perivascular epithelioid cell tumor should be considered in the differential diagnosis of ocular melanocytic lesions. Although most examples appear cytologically bland, experience is limited regarding their malignant potential; and therefore, complete surgical resection and close follow-up are recommended.
Asunto(s)
Cuerpo Ciliar/patología , Neoplasias de los Párpados/patología , Neoplasias de Células Epitelioides Perivasculares/patología , Neoplasias de la Úvea/patología , Adulto , Niño , Cuerpo Ciliar/cirugía , Supervivencia sin Enfermedad , Neoplasias de los Párpados/cirugía , Femenino , Humanos , Inmunohistoquímica , Masculino , Neoplasias de Células Epitelioides Perivasculares/cirugía , Resultado del Tratamiento , Neoplasias de la Úvea/cirugíaRESUMEN
BACKGROUND: The Fasanella-Servat procedure is used for the repair of mild to moderate ptosis. The purpose of this study was to determine the efficacy of the Fasanella-Servat procedure for the repair of several forms of ptosis. METHODS: The authors retrospectively reviewed 169 charts of 2 surgeons from 1988 to 1996. All patients had undergone a Fasanella-Servat procedure for ptosis. Patients with less than a 1-month follow-up were excluded, leaving 153 eyelids of 144 patients. Surgical success was defined as lid symmetry within 0.5 mm or correction of eyelid contour abnormality from previous surgery or trauma. RESULTS: Ptosis was classified as involutional, occurring after intraocular surgery, congenital, due to Horner's syndrome present after levator surgery, and myogenic/other. With a mean follow-up of 7 months, success was achieved in 89.5% of cases (137/153). Among subgroups, success was highest at 100% in Horner's syndrome (8/8) and post-levator surgery (11/11), and lowest in congenital ptosis at 76.4% (13/18). Postoperative problems included dry eye symptoms (6/144 patients), contour abnormalities in 12 lids, and dermatochalasis in 10 lids. INTERPRETATION: The Fasanella-Servat operation is effective for mild to moderate ptosis from a variety of causes and for contour abnormality correction in patients with little or no ptosis. Despite the long-held belief that excision of the accessory lacrimal glands of Wolfring leads to dry eye symptoms, our study found this to be the exception. This procedure has the advantage of high reliability when reasonable preoperative criteria are applied and is minimally invasive.
Asunto(s)
Blefaroptosis/cirugía , Párpados/cirugía , Complicaciones Intraoperatorias , Procedimientos Quirúrgicos Oftalmológicos , Complicaciones Posoperatorias , Anciano , Blefaroptosis/etiología , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
A 57-year-old woman with a six-year history of Graves' Disease with ophthalmopathy developed unilateral periorbital swelling. CT scan suggested a lacrimal mass. Biopsy revealed MALT lymphoma. Evaluation for other sites of lymphoma revealed no other evidence of disease. She was treated with radiation therapy only with complete disappearance of disease. This is the first known case of MALT lymphoma arising in Graves' ophthalmopathy.
