RESUMEN
A rare case of Bacillus panophthlamitis with extension to the prechiasmatic optic nerve secondary to hematogenous spreading after intravenous drug use is presented. A 27-year-old man with a recent history of trauma to the left eye presented with severe left eye pain following a binge of intravenous drug use. Visual acuity (VA) was LP. On examination he had chemosis, proptosis, elevated intraocular pressure, and a complete hyphema. CT-scan identified preseptal swelling, but no evidence of any posterior extension of the anterior process or orbital fractures. Topical and systemic therapy were initiated. On follow-up clinical examination less than 12 hours after presentation he had signs of a keratitis with worsening ophthalmoplegia and repeat imaging demonstrated posterior extension to the prechiasmatic optic nerve. Shortly after the cornea ruptured with cultures growing Bacillus. The patient underwent enucleation and has had no further progression of infection. To the best of our knowledge, this is the first report of Bacillus panophthalmitis presenting with signs of trauma with posterior extension to the prechiasmatic optic nerve.
RESUMEN
A 32-year-old female presented with a sino-orbital lesion that proved to be a NUT midline carcinoma. This is only the third case of orbital involvement by this aggressive lesion. The clinical, radiographic, and histopathologic features of NUT midline carcinoma are discussed, as well as its management options.
Asunto(s)
Carcinoma de Células Escamosas/diagnóstico , Proteínas Nucleares/genética , Proteínas Oncogénicas/genética , Neoplasias Orbitales/diagnóstico , Adulto , Biomarcadores de Tumor/metabolismo , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/terapia , Proteínas de Ciclo Celular , Quimioradioterapia , Cromosomas Humanos Par 15/genética , Cromosomas Humanos Par 19/genética , Femenino , Humanos , Hibridación Fluorescente in Situ , Imagen por Resonancia Magnética , Proteínas de Neoplasias/metabolismo , Neoplasias Orbitales/genética , Neoplasias Orbitales/terapia , Tomografía de Emisión de Positrones , Embarazo , Tomografía Computarizada por Rayos X , Factores de Transcripción/genética , Translocación Genética/genéticaRESUMEN
IgG4-related disease is a recently described fibroinflammatory condition, often with systemic involvement. Several authors have reported IgG4-related orbital inflammation in adults. Pediatric cases of IgG4-related disease have been reported in the literature involving other areas of the body, with only 1 recent report of probable orbital involvement. The first case of probable IgG4-related dacryoadenitis is reported in a child.
Asunto(s)
Dacriocistitis/diagnóstico , Hipergammaglobulinemia/diagnóstico , Inmunoglobulina G/sangre , Aparato Lagrimal/patología , Músculos Oculomotores/patología , Adolescente , Dacriocistitis/sangre , Diagnóstico Diferencial , Femenino , Humanos , Hipergammaglobulinemia/sangre , Imagen por Resonancia Magnética , Seudotumor Orbitario/diagnósticoRESUMEN
The vast majority of periocular squamous cell carcinoma spreads intraorbitally along the supraorbital and infraorbital nerves into the cavernous sinus. A patient presented with a history of resected squamous cell carcinoma and pain in the zygomatic distribution. She was found to have temporalis involvement of the malignancy and invasion of the zygomaticotemporal nerve by histopathology. She underwent aggressive resection and adjuvant treatment with no evidence of recurrence at 8-month follow up. This case illustrates an uncommon route of squamous cell carcinoma spread through the zygomaticotemporal sensory nerve distribution.
