Animal-type malignant melanoma associated with nevus of Ota in the orbit of a Japanese woman: a case report.

We present a patient with an animal-type malignant melanoma associated with the nevus of Ota in the orbit who showed a good prognosis after a combination of orbital extirpation, chemotherapy, stereotactic radiotherapy, and gamma knife. A 42-year-old Japanese woman presented with two tumors, one pathologically diagnosed as right-sided intraconal animal-type malignant melanoma and the other intracranially, presumed to be of the same pathogenesis and both were considered to have arisen from the nevus of Ota. She underwent an extirpation of the orbit, chemotherapy (DAV therapy, which is a combination of dacarbazine, nimustine, and vincristine), stereotactic radiotherapy (54 Gy in 27 fractions), and gamma knife (marginal dose was 17 Gy, target volume was 0.2 ml). She has been alive for 33 months since the extirpation, with no sign of local recurrence, new metastasis, nor enlargement of the intracranial tumor. Not just combination therapy but also the low malignancy of animal-type melanoma may have contributed toward the good prognosis.

Intravitreal gas injection without vitrectomy for macular detachment associated with an optic disk pit.

PURPOSE: To evaluate the clinical outcomes after gas tamponade without vitrectomy for retinal detachment associated with an optic disk pit using optical coherence tomography. METHODS: Intravitreal gas injection was performed on 8 consecutive patients (mean age, 35.0 years; range, 15-74 years) with unilateral macular detachment associated with an optic disk pit. A 0.3-mL injection of 100% sulfur hexafluoride 6 gas was carried out without an anterior chamber tap. Patients treated with gas injection were instructed to remain facedown for 5 days. RESULTS: Complete retinal reattachment after only gas tamponade was achieved in four out of eight eyes. The mean number of gas injections was 1.8. The mean best-corrected visual acuity before and after the treatment with gas tamponade was approximately 30/100 and 20/20, respectively. The period required for reattachment after final gas treatment was 12 months. There were no incidences of recurrence after complete reattachment by gas tamponade in any of the cases during the 94-month average follow-up period (range, 64-132 months). CONCLUSION: Gas tamponade appears to be an effective alternative method for macular detachment associated with an optic disk pit, even though the mechanisms of optic disk pit maculopathy are still unknown.

Occipitoparietal benign osteoblastoma: should entire lesion be resected when magnetic resonance images reveal wide abnormal signal intensity in surrounding bone marrow?

BACKGROUND: Benign osteoblastoma is an uncommon primary bone tumor that usually affects long bones and the vertebral column. Its occurrence in the calvarium is rare. Despite the characteristically benign nomenclature of osteoblastoma, it sometimes recurs with the possibility of transforming into a malignant form after an incomplete resection. Therefore, radical resection is recommended whenever possible. However, it has not been clarified whether the adjacent bones should also be completely resected when magnetic resonance (MR) images reveal abnormal signal intensity in the bone marrow. CASE DESCRIPTION: Presented in this case report is a 12-year-old boy with occipital tenderness associated with occipitoparietal bone tumor. Neuroradiological studies demonstrated a solid tumor located in the occipital bone extending over the right parietal bone. Magnetic resonance images further revealed abnormal signal intensity in the bone marrow of the entire occipital and bilateral parietal bones. Macroscopically, the calvarial bone adjacent to the solid tumor appeared to be reddish, but it was not covering the entire area, contradicting the abnormal intensity found on the preoperative MR images. The resected area was determined according to macroscopic findings, and bones with normal color tone were preserved. Because histological examination did not clearly indicate tumor invasion at the margin of the resection site, no additional therapy was given. Although MR images revealed abnormal intensity in the bone marrow of the surgical margin immediately after the operation, the intensity had been normalized by degrees and there was no evidence of recurrence during a follow-up period of 34 months. This may suggest that bone marrow lesion showing abnormal intensity was edema rather than tumor invasion. CONCLUSIONS: The authors conclude that total resection, including a bone marrow lesion, is not always necessary for benign osteoblastoma. Macroscopic findings that show an abnormal color tone of the cortex could be a good indicator in revealing tumor activity invading bone marrow.