RESUMEN
Orbital volume augmentation to address enophthalmos and hollowing of the superior sulcus has been described with a variety of materials and from a variety of approaches.(1-4) A common location for volume augmentation is the inferomedial orbital wall; this surface is often the one that was expanded related to orbital trauma, and it is easily accessed through hidden conjunctival or caruncular incisions.
Asunto(s)
Enoftalmia/cirugía , Órbita/cirugía , Prótesis e Implantes , Adulto , Materiales Biocompatibles , Párpados/cirugía , Femenino , Humanos , PolietilenosAsunto(s)
Tejido Adiposo/cirugía , Blefaroplastia/métodos , Diplopía/etiología , Trastornos de la Motilidad Ocular/etiología , Complicaciones Posoperatorias/etiología , Ritidoplastia/métodos , Adulto , Cicatriz/etiología , Cicatriz/cirugía , Diplopía/cirugía , Femenino , Humanos , Persona de Mediana Edad , Trastornos de la Motilidad Ocular/cirugía , Complicaciones Posoperatorias/cirugía , Reoperación , SuturasRESUMEN
We report the clinicopathologic features of a 22-year-old patient with aneurysmal bone cyst and fibrous dysplasia of the orbit. The patient was evaluated clinically with computed tomography of the orbit before surgery. An orbital biopsy specimen was examined histologically with conventional light microscopy. The lesion was treated with combined neurosurgical and orbital intervention. Clinical evaluation revealed axial and inferior displacement of the globe. Computed tomography revealed a cystic mass in the superotemporal left orbit with adjacent bone erosion. "Ground-glass" thickening of the adjacent frontal bone and sphenoid bone was observed. Microscopic examination showed fibrous stroma with giant cells and hemosiderin-laden macrophages with adjacent trabeculae of woven bone and osteoblast cells. A fronto-orbital craniotomy was performed, the cystic cavity was excised, and the hyperostotic bone was debulked. After treatment, the globe position and patient appearance have improved. There has been no sign of recurrence of the aneurysmal bone cyst. Aneurysmal bone cyst should be considered in patients with fibrous dysplasia that has a cystic component, or in patients with fibrous dysplasia who present with sudden expansion of their lesion.
Asunto(s)
Quistes Óseos Aneurismáticos/etiología , Displasia Fibrosa Ósea/complicaciones , Enfermedades Orbitales/complicaciones , Adulto , Quistes Óseos Aneurismáticos/diagnóstico por imagen , Quistes Óseos Aneurismáticos/patología , Quistes Óseos Aneurismáticos/cirugía , Craneotomía , Displasia Fibrosa Ósea/diagnóstico por imagen , Displasia Fibrosa Ósea/patología , Displasia Fibrosa Ósea/cirugía , Humanos , Masculino , Enfermedades Orbitales/diagnóstico por imagen , Enfermedades Orbitales/patología , Enfermedades Orbitales/cirugía , Tomografía Computarizada por Rayos XRESUMEN
A case of primary acquired melanosis of the conjunctiva primarily treated with topical mitomycin chemotherapy is presented. The patient underwent treatment with one 2-week course of topical mitomycin 0.02% four times daily, followed 4 weeks later by a 2-week course of topical mitomycin 0.04% four times daily, followed by a 3-month course of topical mitomycin 0.02% twice daily. Map biopsies were performed after the initial two courses of mitomycin therapy and 12 months after all courses of mitomycin treatment had been completed. Complete resolution of the conjunctival pigmentation was noted after the final course of treatment. Map biopsies performed at 12 months following completion of treatment showed normal conjunctiva histopathologically. No recurrence of pigmentation was noted in follow-up 26 months after completion of treatment. Topical mitomycin chemotherapy may be a successful primary treatment for primary acquired melanosis of the conjunctiva.