Solitary Fibrous Tumor of the Orbit with Extraorbital Extension: Case Report

Neurosurgery ◽  
2001 ◽  
Vol 49 (5) ◽  
pp. 1241-1245 ◽  
Author(s):  
Satoru Hayashi ◽  
Hideyuki Kurihara ◽  
Junko Hirato ◽  
Tomio Sasaki

ABSTRACT OBJECTIVE AND IMPORTANCE Solitary fibrous tumors (SFTs) are rare tumors of mesenchymal origin that typically arise in the pleura. Only 24 cases of SFTs in the orbit have been reported, all located within the orbit and generally with a benign course. We report the first case of an orbital SFT with extraorbital extension and short-term regrowth. CLINICAL PRESENTATION A 54-year-old man presented with proptosis and double vision that had persisted for 7 months. The tumor extended from the right extraconal inferolateral orbit to the extradural middle cranial fossa and cavernous sinus, via the superior orbital fissure, on magnetic resonance imaging scans. Positron emission tomography with [18F]fluorodeoxyglucose demonstrated faint uptake in the orbital portion. INTERVENTION Resection of the tumor was performed twice, because of short-term regrowth of the residual tumor in the orbit. The histological diagnosis was a SFT. The MIB-1 labeling index was 7% and the mitotic count was 5 mitotic figures/10 high-power fields at the time of the second operation. These findings indicate the malignant nature of the tumor. CONCLUSION The natural history of SFTs of the orbit remains unclear, and the importance of careful and continued follow-up monitoring of the tumor should be emphasized.

2018 ◽  
Vol 127 (3) ◽  
pp. 209-212
Author(s):  
Sameer A. Alvi ◽  
Joel W. Jones ◽  
Jim Lin

Objectives: To describe a unique case of bilateral dehiscence of the malleus and incus heads into the middle fossa making contact with the temporal lobes, along with its clinical implications. Methods: An analysis of a patient case and review of pertinent literature were performed. Results: A patient with a history of right-sided mastoidectomy for cholesteatoma was evaluated for persistent conductive hearing loss. On computed tomography (CT) and magnetic resonance imaging (MRI), the patient had a complete dehiscence of the tegmen tympani on the right, with ossicular heads being located above the floor of the middle cranial fossa. A similar finding to a milder degree was noted on the left. The patient underwent revision tympanoplasty with mastoidectomy with removal of the incus and ossicular chain reconstruction and middle fossa craniotomy for repair of the right epitympanic dehiscence. Conclusions: We present some of the unique imaging and operative findings involved in an unusual presentation of encephalocele in which the bilateral malleus and incus heads rise above the level of the middle fossa floor.


Author(s):  
Faisal ◽  
Tommy Rizky Hutagalung ◽  
Ridha Dharmajaya

Introduction: Meningiomas of the sphenoid wing make up approximately 15–20% of total cranial meningiomas.Giant medial sphenoid involve the dura of the greater and lesser wings of the sphenoid, the anterior clinoid process,the spheno-orbital bone and the middle cranial fossa, hyperostosis bone was common to found. Surgicalmanagement of giant medial sphenoid is extremely challenging due to their intimate relationship with vital neuralstructures.Case Report : A 40-year-old woman came to the emergency room with complaints of decreased consciousness thathad been experienced since 1 week , recurrent headaches, weakness of the right limb and history of blurred vision. Anon-contrast head ct scan and MRI brain contrast revealed an extra-axial giant mass meningioma in left medialsphenoid wing with hyperostosis bone Craniectomy tumor removal was performed with a subtemporal approachcombined with cranio-orbytozygotomy.Discussion : Hyperostosis is a common phenomenon occuring in different meningiomas with incidence rangingfrom 25 to 49% of meningiomas.it is most commonly seen in sphenoid wing and convexity meningioma . The bonyhyperostosis is of neoplastic nature and is responsible for many of the clinical manifestation of such tumors andhence should be totally drilled to achieve cure and avoid recurrence.Conclusion : Sphenoid wing meningioma en plaque, mainly meningothelial meningiomas, are characterized by theassociated bony hyperostosis that gives them a distinct radiological appearance. Extensive tumor removal is crucialfor correction of proptosis and adequate visual decompression to achieve satisfactory cosmetic and functionaloutcome.


2019 ◽  
Vol 13 (1) ◽  
pp. 58-65
Author(s):  
Takashi Tashiro ◽  
Fumihiro Uwamori ◽  
Yukiomi Nakade ◽  
Tadahisa Inoue ◽  
Yuji Kobayashi ◽  
...  

Gastrointestinal stromal tumors (GISTs) are known to originate specifically from the intestinal cells of Cajal located in the gastrointestinal mesenchyme. GISTs developing outside of the digestive tract have barely been reported. We encountered a first case of large primary GISTs in the liver with cystic changes. A 63-year-old man with a past history of brain infarction visited our hospital. The computed tomography (CT) revealed a 6-cm and a 10-cm mass in the right and the caudal lobe of the liver, respectively. These tumors have marginal enhancement in the arterial phase; however, they presented as hypodense in the internal tumor sites. Both liver tumors had cystic changes. Gastrointestinal examinations using endoscopy revealed no other gastrointestinal tumors, and [18F]-fluoro-2-deoxy-D-glucose positron emission tomography/CT revealed multiple bone metastases in addition to the liver tumors. The liver tumor specimens were composed of spindle cells, and the immunohistochemical staining for c-Kit and for DOG1, as discovered on GIST, was positive. The patient was diagnosed with primary hepatic GIST with cystic changes.


2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Hae Won Jung ◽  
Chong Rae Cho ◽  
Ji Yoon Ryoo ◽  
Hyun Kyo Lee ◽  
So Young Ha ◽  
...  

Actinomyces meyeriis an uncommon cause of human actinomycosis. Here, we report a rare case of empyema caused byA. meyeri. A 49-year-old male presented with a history of 10 days of dyspnea and chest pain. A large amount of loculated pleural effusion was present on the right side and multiple lung nodules were documented on radiological studies. A chest tube was inserted and purulent pleural fluid was drained.A. meyeriwas isolated in anaerobic cultures of the pleural fluid. The infection was alleviated in response to treatment with intravenous penicillin G (20 million IU daily) and oral amoxicillin (500 mg every 8 hours) for 4 months, demonstrating that short-term antibiotic treatment was effective.


2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
S. Cutting ◽  
C. Davies-Husband ◽  
C. Poitelea

The majority of cases of orbital emphysema are due to trauma. Complications are rare, and therefore, the need for surgical intervention is uncommon. We present the first case of which we are aware in which nontraumatic orbital emphysema led to orbital compartment syndrome and subsequent optic nerve dysfunction. The patient underwent emergency needle decompression. A 51-year-old man presented to the Emergency Department with right-sided unilateral proptosis, reduced visual acuity, and binocular diplopia. This occurred after performing a Valsalva manoeuvre with no history of head trauma. He also mentioned that over the past year he had experienced multiple episodes of transient proptosis occurring after Valsalva manoeuvres. Visual acuity in the right eye was reduced to 6/21. A relative afferent pupillary defect was present and intraocular pressure (IOP) was 12 mmHg. The CT scan showed significant orbital emphysema in the medial aspect of the right orbit. Needle decompression was performed resulting in immediate resolution of his symptoms. This case demonstrates that, in cases of orbital emphysema, a lack of a history of trauma and a normal IOP cannot always be used to rule out serious pathology.


Author(s):  
Ahmet Kale ◽  
Gülfem Başol ◽  
Elif Cansu Gündoğdu ◽  
Emre Mat ◽  
Gazi Yıldız ◽  
...  

Introduction: Piriformis syndrome is an uncommon disease resulting from the piriformis muscle’s compression of the sciatic nerve. Pain and numbness in the buttocks and down the leg are the most common symptoms. This study analyzes the laparoscopic surgical treatment of piriformis syndrome. Methods: We report three cases of piriformis syndrome diagnosed in our hospital. The first case was a 40 years old woman with a 7-year history of intermittent low back pain and sciatica on her right side. Hyperesthesia and cutaneous allodynia were observed in the right sciatic nerve dermatome. The second case was a 30 years old woman with a 2-year history of sciatica on her left side. The third case was a 30 years old woman with a 2-year history of sciatica on her right side. All the patients underwent laparoscopic decompression surgery, which was performed to release the sciatic nerve or sacral nerve roots. Results: The patients were reexamined at the postoperative 3rd and 6th months. Their visual analog scale (VAS) scores were found to be decreased from 10/10, 9/10, and 7/10 to 0/10, 1/10, and 0/10, respectively. Conclusion: Due to the very few cases in the literature, pelvic piriformis syndrome is an exclusively clinical diagnosis. If the sciatica is refractory to conservative treatments, laparoscopic exploration and decompression surgery of the pelvic nerves and piriformis muscle could be an option.


2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Paul Burchard ◽  
Alan A Thomay

Abstract A 53-year-old Caucasian male presented with a 2-week history of abdominal distension, pain, nausea and lethargy. His symptoms began 1 day after an all-terrain vehicle accident during which he suffered blunt-force trauma to his mid-right abdomen. CT scan demonstrated abnormal thickening of the ascending colon and terminal ilium with surrounding inflammation within the retroperitoneum and colonic mesentery. Given his likely mechanism and symptomatic improvement, he was initially managed conservatively. However, he was readmitted with recurrence of symptoms, and a repeat CT scan demonstrated no interval improvement. An exploratory laparotomy was performed and a firm, fixed mass of the right-colon and colonic mesentery was found. Final histopathology of the mass revealed a diffuse lymphoid infiltrate with numerous mitotic figures and apoptotic cells. Immunohistochemical staining was positive for CD45, CD20, CD10, and BCL-6 and negative for CD3, TdT, and BCL-2, indicating a diagnosis of Burkitt lymphoma.


2019 ◽  
pp. 112067211987007
Author(s):  
Jayati Sarangi ◽  
Aanchal Kakkar ◽  
Diya Roy ◽  
Rishikesh Thakur ◽  
Chirom Amit Singh ◽  
...  

Purpose: To describe a rare presentation of a case of intraocular non-teratoid medulloepithelioma with teratoid metastases in ipsilateral intraparotid lymph nodes. Case description: A 9-year-old male child with previous history of ciliary body non-teratoid medulloepithelioma presented with a swelling in the right pre-auricular region for 1 month. Magnetic resonance imaging and positron emission tomography–computed tomography showed a right intraparotid mass with enlarged ipsilateral cervical lymph nodes. A core biopsy was taken from the lesion, which on microscopy showed a tumor composed of small round cells arranged in cords, tubules lined by multilayered cells, and in cribriform pattern. These cells were embedded in a hypocellular, loose myxoid matrix. Based on the histopathological characteristics and previous history, a diagnosis of medulloepithelioma metastastic to ipsilateral parotid gland was made. The patient underwent right total conservative parotidectomy and bilateral neck dissection. Histopathological examination revealed metastatic medulloepithelioma in five out of eight intraparotid lymph nodes, with extranodal extension into the adjacent parotid parenchyma. Foci of hyaline cartilage were identified within the tumor, leading to a diagnosis of metastatic teratoid medulloepithelioma. Conclusion: Intraparotid lymph node metastases from intraocular medulloepithelioma is a rare possibility and we recommend that the parotid should be evaluated in cases of intraocular medulloepithelioma at initial presentation as well as during the follow-up period. Also, metastasis should be considered in all pediatric patients with solitary mass lesions showing unconventional histology for a primary parotid neoplasm.


2015 ◽  
Vol 156 (28) ◽  
pp. 1140-1143
Author(s):  
István Hartyánszky ◽  
Márta Katona ◽  
Krisztina Kádár ◽  
Asztrid Apor ◽  
Sándor Varga ◽  
...  

Aortico-left ventricular tunnel is a rare congenital cardiac defect, which bypasses the aortic valve via the paravalvar connection from the aorta to the left ventricle. The authors report the history of a 14-year-old boy with aortico-left ventricular tunnel in whom the aortic orifice arose from the right aortic sinus and was closed by a pericardial patch. The diagnosis was confirmed by combined two-dimensional and real time three-dimensional echocardiogram and magnetic resonance imaging. This is the first case, in which these complex diagnostic imaging methods have been used in the pre- and postoperative management of this defect. Optimally the new transthoratic three-dimensional echocardiography would be needed to define the anatomy and functional consequences of the aortico-left ventricular tunnel and in the postoperative follow-up. Orv. Hetil., 2015, 156(28), 1140–1143.


2014 ◽  
Vol 128 (1) ◽  
pp. 60-63 ◽  
Author(s):  
S Genc ◽  
M G Genc ◽  
I B Arslan ◽  
A Selcuk

AbstractAim:This study aimed to determine whether or not the middle cranial fossa dural plate is located lower (i.e. more caudally) in patients with chronic otitis media, relative to adjacent structures.Methods:The authors retrospectively investigated computed tomography temporal bone scans of 267 ears of 206 patients who had undergone surgery with a diagnosis of chronic otitis media, together with scans of 222 ears of 111 patients without chronic otitis media. The depth of the middle cranial fossa dural plates was recorded.Results:The mean depth of the middle cranial fossa dural plate was 4.59 mm in the study group and 2.71 mm in the control group (p < 0.001). The middle cranial fossa dural plate was located lower in the right ear in both the study and control groups.Conclusion:The middle cranial fossa dural plate was located lower in patients with chronic otitis media, and in the right ears of both patients and controls. Surgeons should take this low location into consideration, and take extra care, during relevant surgery on patients with chronic otitis media.


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