RESUMO
CASO CLÍNICO: Presentamos el caso de un osteoma frontoetmoidal derecho con invasión intraorbitaria en un varón de 43 años que comenzó como un cuadro de dolor retroocular con proptosis, inflamación peripalpebral y diplopía binocular por limitación del recorrido muscular. Se realizó cirugía abierta mediante abordaje subcraneal anterior, con extirpación de varios fragmentos de osteoma, cuyo análisis histológico confirmó el diagnóstico. DISCUSIÓN: Los osteomas son tumores benignos formadores de hueso de crecimiento lento. Habitualmente son asintomáticos, hasta que producen complicaciones por efecto masa en el cerebro o en la órbita, o a nivel local, hasta que obstruyen el drenaje del seno donde asientan, generando mucoceles
CASE REPORT: A case is presented of a right frontoethmoidal osteoma with intraorbital invasion in a 43-year-old male, who was seen in the clinic with a proptosis, retro-orbital pain, peri-palpebral inflammation, and binocular diplopia due to muscular route limitation. Open surgery was performed using a subcranial approach, with removal of several fragments of osteoma. Histological analysis confirmed the diagnosis. DISCUSSION: Osteomas are benign bone-forming tumours with slow growth. They are usually asymptomatic until mass effect complications occur in the brain or in the orbit, or locally, generating mucoceles due to sinus drainage obstruction
Assuntos
Humanos , Masculino , Adulto , Osteoma/complicações , Osteoma/tratamento farmacológico , Osteoma , Exoftalmia/complicações , Diplopia/complicações , Diplopia/tratamento farmacológico , Toxinas Botulínicas Tipo A/uso terapêutico , Seio Etmoidal/patologia , Seio Etmoidal , Combinação Amoxicilina e Clavulanato de Potássio/uso terapêutico , Prednisona/uso terapêutico , Omeprazol/uso terapêutico , Dipirona/uso terapêuticoRESUMO
CASE REPORT: A case is presented of a right frontoethmoidal osteoma with intraorbital invasion in a 43-year-old male, who was seen in the clinic with a proptosis, retro-orbital pain, peri-palpebral inflammation, and binocular diplopia due to muscular route limitation. Open surgery was performed using a subcranial approach, with removal of several fragments of osteoma. Histological analysis confirmed the diagnosis. DISCUSSION: Osteomas are benign bone-forming tumours with slow growth. They are usually asymptomatic until mass effect complications occur in the brain or in the orbit, or locally, generating mucoceles due to sinus drainage obstruction.
Assuntos
Seio Etmoidal/patologia , Seio Frontal/patologia , Órbita/patologia , Osteoma/patologia , Neoplasias dos Seios Paranasais/patologia , Adulto , Diplopia/etiologia , Seio Etmoidal/diagnóstico por imagem , Seio Etmoidal/cirurgia , Exoftalmia/etiologia , Seio Frontal/diagnóstico por imagem , Seio Frontal/cirurgia , Humanos , Imageamento Tridimensional , Masculino , Invasividade Neoplásica , Órbita/diagnóstico por imagem , Osteoma/complicações , Osteoma/diagnóstico por imagem , Osteoma/cirurgia , Neoplasias dos Seios Paranasais/complicações , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Neoplasias dos Seios Paranasais/cirurgia , Complicações Pós-Operatórias/etiologia , Tomografia Computadorizada por Raios X , Torcicolo/etiologiaRESUMO
PURPOSE: To compare the results of combined phacotrabeculectomy by means of a one-site versus two-site approach. MATERIALS AND METHODS: A retrospective study has been performed over 35 glaucomatous patients with a coexisting cataract, treated with a one-site (19 cases) or a two-site (16 cases) phacotrabeculectomy. First, effectiveness of both procedures has been proved by statisticly analysing the IOP and visual acuity changes after surgery. Normal distribution, homogeneity and homocedasticity from both groups have been checked. Finally, visual acuity and 6-month postoperatively IOP among both groups have been compared by means of a <
Assuntos
Catarata/complicações , Glaucoma/complicações , Facoemulsificação/métodos , Trabeculectomia/métodos , Idoso , Feminino , Glaucoma/cirurgia , Humanos , Pressão Intraocular , Masculino , Estudos Retrospectivos , Acuidade VisualRESUMO
Objetivo: Comparar los resultados de la faco-trabeculectomía realizada mediante una única incisión frente a la realizada mediante dos incisiones independientes. Material y métodos: Se realiza un estudio retrospectivo de 35 pacientes diagnosticados de glaucoma crónico y catarata, intervenidos mediante facotrabeculectomía por vía única (n=19) o por dos vías independientes (n= 16). En primer lugar se verifica la eficacia de ambas técnicas analizando estadísticamente las variaciones de PIO y agudeza visual, y se comprueba en ambas muestras normalidad, homogeneidad y homocedasticidad. Posteriormente se compara la agudeza visual y la PIO a los seis meses de la cirugía entre los dos grupos mediante test de diferencia de medias de t de Student para muestras independientes. Conclusión: La facotrabeculectomía es una opción terapéutica eficaz para pacientes glaucomatosos afectos de catarata, con buenos resultados visuales y tensionales. La utilización de una única incisión o dos independientes en el abordaje de la técnica aporta los mismos resultados a los seis meses (AU)
Assuntos
Idoso , Masculino , Feminino , Humanos , Trabeculectomia , Facoemulsificação , Estudos Retrospectivos , Catarata , Pressão Intraocular , Glaucoma , Acuidade VisualRESUMO
PURPOSE: To evaluate the factors involved in the development of consecutive exotropia (XTc), and the surgical procedures used for its treatment. PATIENTS AND METHODS: A retrospective study on 30 patients who underwent surgery for XTc was carried out in our Department. The following characteristics were studied prior to surgery: anamnesis, refraction, deviation angle measurement, detection of amblyopia and diplopia prior to the operation, abnormal head posture rotations and presence of any vertical deviation and anisotropy. The surgical technique used was individually considered for each patient and included bilateral lateral rectus recessions and/or unilateral medial rectus advancement to its/their original insertion site. RESULTS: Before surgery, 53.33% of our patients showed amblyopia, 66.66% of them showed rotation limitation, 46.66% showed dissociated vertical deviation (DVD), 20% had abnormal head posture and 10% diplopia. <
Assuntos
Exotropia/cirurgia , Adolescente , Adulto , Criança , Humanos , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Oftalmológicos/métodos , Estudos RetrospectivosRESUMO
Objetivo: Evaluar los factores que influyen en la aparición de la exotropía consecutiva (XTc), así como sus procedimientos quirúrgicos correctores. Material y métodos: Hemos realizado un estudio restrospectivo en nuestro departamento, incluyendo 30 pacientes operados de XTc. Antes de la cirugía se estudiaron los siguientes aspectos: anamnesis, retracción, ángulo de desviación, detección de ambliopía y diplopía, y exploración de ducciones, tortícolis y anisotropía. La técnica empleada fue individualizada para cada paciente. Se realizó retroinserción de uno o ambos rectos laterales; también se hicieron avanzamientos del recto medio operado previamente. Material y métodos: Hemos realizado un estudio restrospectivo en nuestro departamento, incluyendo 30 pacientes operados de XTc. Antes de la cirugía se estudiaron los siguientes aspectos: anamnesis, retracción, ángulo de desviación, detección de ambliopía y diplopía, y exploración de ducciones, tortícolis y anisotropía. La técnica empleada fue individualizada para cada paciente. Se realizó retroinserción de uno o ambos rectos laterales; también se hicieron avanzamientos del recto medio operado previamente. Resultados: Preoperatoriamente se encontraron un 53,33 por ciento de pacientes con ambliopía, un 66,6 por ciento de limitación de las ducciones, un 46,6 por ciento de DVD, un 20 por ciento de tortícolis y un 10 por ciento de diplopías. En la mayoría de los casos (70 por ciento) el resultado fue 'bueno' (ángulo residual de menos de 10 dioptrías prismáticas). En más de la mitad de los pacientes una cirugía fue suficiente para solventar la XTc. Conclusiones: En nuestro estudio se demuestra que la ambliopía, la limitación de las ducciones, las alteraciones verticales (DVD y síndromes alfabéticos) son las alteraciones más frecuentemente encontrados en la XTc. Los resultados indican que, en un 70 por ciento de los pacientes tratados por nosotros, se consigue un ángulo residual de menos de 10 dioptrías prismáticas (DP). La técnica de elección es la doble recesión de rectos laterales, cuando la desviación es menor a 35 DP; cuando es mayor, es necesario un avanzamiento de uno o ambos rectos mediales (AU)
Assuntos
Pessoa de Meia-Idade , Criança , Adulto , Adolescente , Humanos , Procedimentos Cirúrgicos Oftalmológicos , Estudos Retrospectivos , ExotropiaAssuntos
Neoplasias dos Ductos Biliares/secundário , Neoplasias da Mama/patologia , Carcinoma/secundário , Colestase Extra-Hepática/etiologia , Ducto Hepático Comum , Neoplasias dos Ductos Biliares/complicações , Neoplasias dos Ductos Biliares/patologia , Carcinoma/complicações , Carcinoma/patologia , Colestase Extra-Hepática/patologia , Feminino , Ducto Hepático Comum/patologia , Humanos , Pessoa de Meia-IdadeRESUMO
We have retrospectively studied 35 cases of Kaposi's sarcoma in 460 patients with AIDS (incidence of 7.6%) during a period of 10 years. All of them were males, with a mean age of 38 years. 88% of the cases belonged to the homosexual risk group. The tumor was the diagnostic criteria of AIDS in 25 patients. At the moment of the diagnosis, 4 patients were at stage I, 23 at stage II, 1 at stage III and 7 at stage IV, according to the Mitsuyasu's classification; 7 patients had systemic symptoms. The tumor was localized at the skin (34 cases), mucosa (16), digestive tract (7), lung (6) and ganglion (4). The immunological study revealed lymphopenia in 74% of patients, reduction of T4 lymphocytes ( < 0.5 x 10(9)/L) in 93% and inverted T4/T8 ratio in 96%. Sixteen patients received antitumoral treatment (8 with chemotherapy, 7 with interferon and 5 with radiotherapy). The response was stabilization of lesions in 8 cases, partial remission in 2 and progression in 3; in other 3 cases, such response was not assessed. The mortality was 48% and the average survival, 13 months. Opportunistic infections were the cause of death in most patients. Our results confirm the clinical and evolutive characteristics of the Kaposi's sarcoma associated to AIDS; disseminated cutaneous affectation with frequent visceral affectation, poor response to treatment and low survival associated to the presence of opportunistic infections. The lower incidence of tumor observed in our study is related to the different distribution of the risk groups for HIV in our country.
Assuntos
Síndrome da Imunodeficiência Adquirida/epidemiologia , HIV-1 , Sarcoma de Kaposi/epidemiologia , Síndrome da Imunodeficiência Adquirida/complicações , Síndrome da Imunodeficiência Adquirida/mortalidade , Síndrome da Imunodeficiência Adquirida/patologia , Síndrome da Imunodeficiência Adquirida/terapia , Adulto , Terapia Combinada , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Sarcoma de Kaposi/etiologia , Sarcoma de Kaposi/mortalidade , Sarcoma de Kaposi/patologia , Sarcoma de Kaposi/terapia , Espanha/epidemiologiaAssuntos
Traumatismos do Nascimento , Traumatismos da Medula Espinal/etiologia , Traumatismos do Nascimento/patologia , Vértebras Cervicais/lesões , Eletroencefalografia , Feminino , Humanos , Recém-Nascido , Imageamento por Ressonância Magnética , Masculino , Medula Espinal/patologia , Traumatismos da Medula Espinal/diagnóstico , Traumatismos da Medula Espinal/patologia , Tomografia Computadorizada por Raios XRESUMO
PURPOSE: To assess in a retrospective fashion the appearance of lymphoid malignancies in subjects infected by the human immunodeficiency virus, or included in any risk-group, between January 1984 and June 1991. MATERIAL AND METHODS: Twenty-six patients with AIDS-related lymphoma (23 non-Hodgkin's lymphoma (NHL) and 3 Hodgkin's disease (HD) cases) were entered in the study. Of them, 25 were males, with a mean age of 27 years. Eleven were intravenous drug abusers, eight were homosexuals, five were haemophiliacs and two were heterosexuals. RESULTS: The NHL histologic subtypes found were: small, non cleaved cell (Burkitt's), 14 cases; immunoblastic, 2 cases; diffuse, large cell, 1 case; anaplastic, 1 case; extramedullary plasmacytoma, 1 case, and high grade, unclassifiable, 4 cases. The malignant cell immunophenotype was B in 95% of the cases. The pathological stage at diagnosis was IV-B in 16 cases, IV-A in 3, III-B in 1 and I-E in 3. Extranodal involvement was seen in 95% of the patients, mainly extended to the bone marrow (53%), liver (48%) central nervous system (35%) and digestive tract (22%). The three HD patients (2 with lymphocytic depletion and 1 with mixed cellularity) were in stage IV-B at diagnosis, with bone marrow involvement. Twenty-three patients received chemotherapy, 7 were treated with radiotherapy, and 4 underwent surgery. Complete remission (CR) was attained in 35% of the cases and partial response in 55%. The median survival of the series is 7 months, and that of the CR patients is 20 months (p less than 0.001). The series mortality was 77%, mostly related to disease progression or opportunistic infection. CONCLUSION: The general characteristics of AIDS-related lymphoma were confirmed here: aggressive clinical course, poor response to therapy and high risk of opportunistic infections. The possibility of achieving CR may justify the use of combination chemotherapy in patients with good functional status.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Linfoma/etiologia , Síndrome da Imunodeficiência Adquirida/mortalidade , Análise Atuarial , Adolescente , Adulto , Criança , Terapia Combinada , Feminino , Humanos , Imunofenotipagem , Linfoma/sangue , Linfoma/classificação , Linfoma/imunologia , Linfoma/mortalidade , Linfoma/patologia , Linfoma/terapia , Masculino , Infecções Oportunistas/etiologia , Infecções Oportunistas/mortalidade , Estudos Retrospectivos , Fatores de Risco , Análise de SobrevidaRESUMO
In LCH extended disease CNS involvement in is not infrequent. Diabetes insipidus, due to the affectation of hypothalamus-hypophysis axis, is its most frequent finding. The solitary affectation of hypothalamus-hypophysis axis is exceptional. At times, it's a difficult diagnosis and could precede the diagnosis of LCH several years. Usually, CAT and NMR show morphologic lesions. We report a patient who was diagnosed of idiopathic diabetes insipidus when he was 16 years old. Seven year later, he was diagnosed of LCH after underwent a bone marrow biopsy examination, just when the disease involved the bone and lung. Cerebral CAT and NMR didn't show morphologic lesions. In the presence of morphologic lesions in hypothalamus and/or hypophysis, proved by cerebral CAT and NMR, or a clinical setting of DI, the possibility of LCH must be considered.