scholarly journals Two Late Recurrences of Conjunctival Melanoma

2018 ◽  
Vol 5 (4) ◽  
pp. 262-266 ◽  
Author(s):  
Niels J. Brouwer ◽  
Stijn W. Genders ◽  
Marina Marinkovic ◽  
Sjoerd G. van Duinen ◽  
Martine J. Jager ◽  
...  

Purpose: To report a patient who developed two late recurrences of conjunctival melanoma (CoM), of which one occurred after orbital exenteration. Methods: We describe the case of a patient based on clinical and histopathological examination. Results: A 52-year-old patient was treated with local excision and cryotherapy for a CoM with primary acquired melanosis (PAM) near the limbus of the right eye. Twenty-one years later, a recurrence developed in the superior fornix of the same eye in an area with widespread PAM; an orbital exenteration was performed. After another 4 years, a painful nodule developed subcutaneously at the inferior margin of the right orbital socket. Pathology showed a recurrence of CoM with a BRAF V600K mutation, similar to both of the previous lesions (of 25 and 4 years earlier). The nodule was excised without additional therapy. No recurrences or metastases have been observed in the next 2.5 years. The proposed mechanism for the recurrence after surgery could be via dormant tumor cells that have spread prior to the procedure or via residual intraepithelial malignant melanocytes. Conclusion: Very late recurrences of CoM are rare but may occur. Our case illustrates the need for long-term awareness of doctors and patients, even after extensive surgical procedures such as orbital exenteration.

2019 ◽  
Vol 11 (3) ◽  
pp. 89-93
Author(s):  
Yohanes Widjaja ◽  
Khairuddin Djawad ◽  
Saffruddin Amin ◽  
Widyawati Djamaluddin ◽  
Dirmawati Kadir ◽  
...  

Abstract Introduction. Leprosy is a disease that predominantly affects the skin and peripheral nerves, resulting in neuropathy and associated long-term consequences, including deformities and disabilities. According to the WHO classification, there are two categories of leprosy, paucibacillary (PB) and multibacillary (MB). The standard treatment for leprosy employs the use of WHO MDT (Multi Drug Treatment) regimen, despite its multiple downsides such as clofazimine-induced pigmentation, dapsone-induced haematological adverse effects, poor compliance due to long therapy duration, drug resistance, and relapse. Multiple studies and case reports using ROM regimen have reported satisfactory results. Nevertheless, there are still insufficient data to elucidate the optimum dosage and duration of ROM regimen as an alternative treatment for leprosy. Previous experience from our institution revealed that ROM regimen given three times weekly resulted in a satisfactory outcome. Case Reports. We report two cases of leprosy treated with ROM regimen from our institution. The first case was PB leprosy in a 64-year-old male who presented with a single scaly plaque with erythematous edge on the right popliteal fossa. Sensibility examination showed hypoesthesia with no peripheral nerve enlargement. Histopathological examination confirmed Borderline Tuberculoid leprosy. ROM regimen was started three times weekly for 6 weeks and the patient showed significant clinical improvement at the end of the treatment with no reaction or relapse until after 6 months after treatment. The second case was MB leprosy in a 24-year-old male patient with clawed hand on the 3rd-5th phalanges of the right hand and a hypoesthetic erythematous plaque on the forehead. Histopathology examination confirmed Borderline leprosy. The patients received ROM therapy 3 times a week with significant clinical improvement after 12 weeks. Conclusion. ROM regimen given three times weekly for 6 weeks in PB leprosy and 12 weeks in MB leprosy resulted in a significant clinical improvement. Thus, ROM regimen could be a more effective, safer, faster alternative treatment for leprosy.


2016 ◽  
Vol 44 (1) ◽  
pp. 4
Author(s):  
Luis Felipe Dutra Corrêa ◽  
Rafael Oliveira Chaves ◽  
Marília Teresa De Oliveira ◽  
João Pedro Scusssel Feranti ◽  
Bruna Copat ◽  
...  

 Background: Melanoma is a primary ocular neoplasm that may affect the iris, ciliary body, the choroid coat and others components of the eye. The ocular melanomas have a low metastatic level in dogs when compared to cats. Old animals are more affected than the young ones and there is no breed predilection. A complete eye examination and ocular ultrasound will lead to the diagnosis that will be further confirmed through histopathology. Current treatment of choice is based on the size and the structures involved by the tumor that can range from local resection to orbital exenteration. The objective of this study is to report a case of iris melanoma involving the ciliary body and the choroid coat of a Poodle, emphasizing its clinical manifestation, diagnosis and treatment.Case: This study reports a case of an intact male canine Poodle, 15 years old, weighing 5 kg that was referred for care to the Veterinary Teaching Hospital of the Federal University of Santa Maria, Brazil. The owner initially presented a history of a progressive increase dark-colored intraocular volume in the right eye iris of the dog. On the clinical examination, no abnormality was found. On the ophthalmic examination, the right eye possessed misshapen pupil, hyperemia ocular conjunctiva (+) and diffuse corneal opacity (+) with paracentral pigmentation between 7-10 hour. On biomicroscopic ex­amination, using a slit lamp, it was observed an iris distension that was protruding directly into the anterior chamber and a diffuse opacity of the lens. Intraocular pressure was eight mmHg. B-mode ultrasonography revealed a mass involving the iris, ciliary body and the choroid coat with perilesional retinal detachment, suggesting iris ciliary body and choroid mela­noma. Due to the bad prognosis of the affected eye, the patient underwent to orbital exenteration procedure. The extracted eyeball was placed in 10% formalin and sent for histopathological examination, which was later reported as showing an iris melanoma involving the ciliary body and the choroid coat. The patient was re-examined six months postoperatively and no neoplasm recurrence signs were observed.Discussion: The animal stated in this report showed an increased volume of the right eye and dark pigmentation involving the iris. As highlighted by the actual literature, the size of this kind of neoplasm can vary from small to larger nodules and it can causes relevant anatomical changes. The pigmentation in these cases may vary from dark colors (black or brown) to white, for example, the amelanotic melanomas. In this report it was observed a nodular staining quite blackened pig­mentation. This kind of cancer involves mainly not neutered male dogs, with breed predilection as the German shepherd dogs, Golden Retrievers, Labrador Retrievers and also Poodles, as reported in this case. The treatment suggested by the literature, can range from diode laser therapy to microsurgical resection with enucleation or exenteration, depending on the size of the affected region and structures involved. The treatment of choice in this patient was the orbital exenteration because of the capacity of this tumor to spread throughout the uvea and it was not sure whether scleral infiltration could already exist, although the enucleation could also be indicated. However, through the histopathological examination, it could be confirmed that the neoplasm was located only at iris, involving also the ciliary body and choroid coat without sclera leakage, so there would be no need for exenteration. The average age of the patients is around nine years old ac­cording to published reports, namely older animals as the patient here described. The orbital exenteration technique, with good safety margin resection, proved to be efficient for the surgical treatment of iris melanoma involving the ciliary body and the choroid coat.Keywords: ophthalmology, neoplasm, uvea.


2021 ◽  
Author(s):  
Jingya Fan ◽  
Lei Guo ◽  
Peng Teng ◽  
Xiaoyi Dai ◽  
Qi Zheng ◽  
...  

Abstract Background: Cardiac hemangiomas are rare in all kinds of benign cardiac tumors. Although cardiac hemangiomas affect all ages and may occur anywhere within the heart, right ventricular hemangiomas are extremely uncommon.Case presentation: We report a 56-year-old woman presented with chest tightness and breath shortness for 3 months. Transthoracic echocardiography and coronary computed tomography angiography showed a mass located adjacent to the apex of the right ventricle but both failed to figure out where the mass originated from, remaining a diagnostic mystery preoperatively. The mass was removed successfully and the histopathological examination confirmed it was hemangioma.Conclusions: Cardiac magnetic resonance should be the ultimate diagnostic tool of cardiac tumors. Surgical removal, associated with a low recurrence rate and long-term survival benefits, should be the first choice of therapy for cardiac hemangiomas.


2020 ◽  
Vol 6 (4) ◽  
pp. 287-292
Author(s):  
Jose J. Echegaray ◽  
Gabrielle Yeaney ◽  
Rachel Chen ◽  
Arun D. Singh

Purpose: To report a case of local metastasis of conjunctival melanoma, which may occur via extravascular migratory metastasis (EVMM), and discuss its clinical relevance in conjunctival melanoma tumor staging and possible management implications. Methods: Retrospective chart review of a single clinical case with clinicopathologic correlation. Results: A 65-year-old male referred due to local recurrence of conjunctival melanoma at the caruncle was successfully treated after two excisional procedures with negative sentinel lymph node biopsies. Forty-eight months after initial presentation, the patient developed a nodular lesion representing local recurrence in the ipsilateral upper tarsal conjunctiva, distant from the primary tumor site. Histopathology showed nodules in the substantia propria in the absence of primary acquired melanosis. The tumor cells were found along the extravascular surface without intralymphatic or intravascular tumor cells consistent with local metastasis. One possible mechanism is angiotropic microsatellitosis leading to local EVMM. Additional neck CT imaging showed no lymphadenopathy. Conclusion: EVMM via angiotropic microsatellitosis is another possible mechanism of noncontiguous local recurrence of conjunctival melanoma. Angiotropic microsatellitosis may represent a high-risk finding possibly related to increased melanoma-related mortality.


2021 ◽  
Vol 13 (1) ◽  
pp. 136-140
Author(s):  
Brian Andrés García Orellana ◽  
María de Lourdes León Vintimilla ◽  
Martha Alejandra Cornejo Córdova

BACKGROUND: Inflammatory fibrous hyperplasia associated with the use of removable dental prosthesis (IFH) is an adaptive lesion caused by long-term trauma exerted by a poorly adapted removable prosthesis on the oral mucosa, usually in the vestibular sulcus. Its diagnosis and treatment is imperative, due to its potential to cause discomfort to the patient, altering aesthetics, phonectics and chewing. CASE REPORTS: A 41-year-old denture wearer woman was referred due to discomfort in the right lower vestibular sulcus, the clinical examination showed a bilobed enlargement with an invagination where the edge of the prosthesis fits, the patient has worn the prosthesis for 15 years. EVOLUTION: Resection with scalpel (conventional technique) was performed. The histopathological examination reported inflammatory fibrous hyperplasia and a new total removable bimaxillary prosthesis was made for the patient. CONCLUSIONS: HFI is one of the main oral lesions in older adults denture wearers and it causes aesthetic and functional alterations; it is produced by the constant irritation caused by the settlement of the prosthesis borders on the mucovestibular sulcus as a consequence of alveolar resorption. Treatment is meant to eliminate the injury and its etiology; the absence of lesions on the mucosa and the bottom of the sulcus is completely necessary.


2016 ◽  
Vol 10 (11-12) ◽  
pp. 404
Author(s):  
Yanbo Wang ◽  
Xiaobo Ding ◽  
Xiaobo Ma ◽  
Lingbo Yang ◽  
Faping Li ◽  
...  

The prognostic role of chromophobe renal cell carcinoma (ChRCC) is still controversial. Here, we report on a patient who lived with tremendous non-progressed renal malignant tumour for eight years. The 32-year-old patient presented to our hospital with a huge renal tumour. Computed tomography (CT) scan showed a tumour 12 cm in diameter at the upper pole of the right kidney. Trans-abdominal laparoscopic right radical nephrectomy was performed. Histopathological examination confirmed this tumour to be a ChRCC. The phenomenon of long-term non-progressed renal malignant tumour will help us further understand the characteristics of ChRCC.


2014 ◽  
Vol 4 (2) ◽  
pp. 54-57
Author(s):  
B Shrestha ◽  
S Subedi ◽  
S Pandey

Juvenile ossifying fibroma (JOF), one of the fibroosseous lesions is an uncommon clinical entity and involving both jaw is even rarer. Here, we present the case of a 15-year-old female patient with synchronous occurrence of JOF in the right sided maxilla and in the periapical area of mandibular right premolar molar region. After the clinical, radiographical and histopathological examination, the surgical treatment was carried out and the patient was kept under long term follow up. Owning to its aggressive local behaviour and high recurrence, early diagnosis, appropriate treatment and long term regular follow up are of prime importance. DOI: http://dx.doi.org/10.3126/jcmc.v4i2.10867 Journal of Chitwan Medical College 2014; 4(2): 54-57


2012 ◽  
Vol 56 (4) ◽  
pp. 677-680
Author(s):  
Piotr Trębacz ◽  
Marek Galanty

Abstract The aim of the study was to assess the prepubic minilaparotomy approach in the surgical treatment of prostatic disorders in dogs. The technique of a limited approach to the prostate was developed on the fresh cadavers of 14 intact adult male dogs, diversified in regard to size and body weight. The abdominal cavity was opened in midline, from the right-sided prepubic parapenile incision. The cut was limited to 7 cm. Afterwards, it was expanded by self-retaining retractors: Gelpi, Weislander, Finnochetto Baby, and Adson. Finnochetto Baby and Gelpi retractors used in pairs enabled an adequate exposition of the prostate in small dogs. The Finnochetto Baby retractor enabled an adequate exposition of the prostate in medium dogs and the Adson retractor - in large and giant dogs. The Weislander and Gelpi retractors used individually did not allow for sufficient access to the prostate in any group of the cadavers. Prepubic minilaparotomy can be a useful surgical approach in the treatment of prostate disorders in dogs. It can be used especially for minor surgical procedures, e.g. sampling of large tissue specimens for histopathological examination, partial prostatectomy, or treatment of intraparenchymal cavitary lesions.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jingya Fan ◽  
Lei Guo ◽  
Peng Teng ◽  
Xiaoyi Dai ◽  
Qi Zheng ◽  
...  

Abstract Background Cardiac hemangiomas are rare in all kinds of benign cardiac tumors. Although cardiac hemangiomas affect all ages and may occur anywhere within the heart, right ventricular hemangiomas are extremely uncommon. Case presentation We report a 56-year-old woman presented with chest tightness and breath shortness for 3 months. Transthoracic echocardiography and coronary computed tomography angiography showed a mass located adjacent to the apex of the right ventricle but both failed to figure out where the mass originated from, remaining a diagnostic mystery preoperatively. The mass was removed successfully and the histopathological examination confirmed it was hemangioma. Conclusions Cardiac magnetic resonance should be the ultimate diagnostic tool of cardiac tumors. Surgical removal, associated with a low recurrence rate and long-term survival benefits, should be the first choice of therapy for cardiac hemangiomas.


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