Intraocular Schwannoma: Case Series of 28 Patients and Literature Review

Abstract Background: Intraocular schwannoma is a rare intraocular tumor, which is often misdiagnosed. We aimed to analyze the demographics and clinical characteristics of patients with intraocular schwannoma.Methods: Retrospective case series were collected from May 2005 to July 2021 in Beijing Tongren Hospital. Then a literature review was also performed.Results: A total of 28 patients were diagnosed with intraocular schwannoma histopathologically. The median age (range) of the included patients was 39 (12-64) years old, among whom half subjects were female. The most common symptom was visual loss (75.0%), followed by visual field loss (10.7%). Intraocular schwannoma presented as nonpigmented mass, which occurred mainly in ciliary body (42.9%), followed by choroid (32.1%) and ciliochoroid (25.0%).16 patients (57.1%) were clinically misdiagnosed as uveal melanoma. Tumor excision was performed for all patients and increased light transmission was detected in half cases. In the consecutive follow-up (median: 6.0 years, range: 0.5-16.0 years), no recurrence or metastasis case was detected.Conclusions: Intraocular schwannoma is a rare benign intraocular tumor. It usually presents as nonpigmented mass, which is easily misdiagnosed as nonpigmented uveal melanoma.

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Ultrasound Biomicroscopy Documented Anterior Uveal Melanoma Regression after Ruthenium-106 Plaque Therapy

Ocular Oncology and Pathology ◽

10.1159/000512030 ◽

2021 ◽

pp. 1-9

Author(s):

Biljana Kuzmanović Elabjer ◽

Mladen Bušić ◽

Andrej Pleše ◽

Mirjana Bjeloš ◽

Daliborka Miletić ◽

...

Keyword(s):

Uveal Melanoma ◽

Tumor Regression ◽

Corneal Thickness ◽

Case Series ◽

Ultrasound Biomicroscopy ◽

Close Monitoring ◽

Single Institution ◽

Retrospective Case ◽

Caucasian Patients

Introduction: Ultrasound biomicroscopy (UBM) is the only widely used method for the evaluation of anterior uveal melanoma (AUM). Objective: Documentation of regression of AUM treated with ruthenium-106 (Ru-106) plaque types CCB and CCC using UBM. Methods: This single institution-based retrospective case series involved 10 Caucasian patients with AUM followed after brachytherapy with UBM from January 2014 until February 2019. The largest prominence of the tumor perpendicular to the sclera or the cornea (including scleral/corneal thickness) (D) and the largest basal dimension (B) were measured in millimeters with UBM for all patients prior to the brachytherapy and at 4-month interval follow-up. Tumor regression was calculated as a percentage of decrease in the initial D and B values. Results: The study involved 10 patients with a mean age of 64.4 years (yr) (range 46–80 yr). D ranged from 1.82 to 5.5 mm (median 2.99 mm) and B from 2.32 to 12.38 mm (median 4.18 mm). The apical radiation dose in all patients was 100 Gy. The median follow-up was 42.02 months. Regression for D was 21.11 ± 13.66%, 31.09 ± 14.66%, and 34.92 ± 19.86% at 1st, 2nd, and 3rd year of the follow-up, respectively, while for B it was 21.58 ± 16.05%, 28.98 ± 17.71%, and 32.06 ± 18.96%, respectively. Tumor recurrence was documented in 2/10 patients. Conclusion: The major regression of AUM, treated with Ru-106 plaque types CCB and CCC, was documented in the first 2 years after brachytherapy in our study group. In the following years, only minimal regression was documented that warns of the need for close monitoring and active search for local recurrences.

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Corrigendum to “Dissociative sensibility disorders – A retrospective case series and systematic literature review” [Eur J Paediatr Neurol (2018) 27–38]

European Journal of Paediatric Neurology ◽

10.1016/j.ejpn.2018.02.008 ◽

2018 ◽

Vol 22 (3) ◽

pp. 573

Author(s):

Peter Weber ◽

Rahel Erlacher

Keyword(s):

Literature Review ◽

Systematic Literature Review ◽

Case Series ◽

Retrospective Case ◽

Retrospective Case Series

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Management of Refractory Intracranial Hypotension Using Percutaneous Fibrin Sealant Patch – A Case Series and Review of the Literature

Pain Management Case Reports ◽

10.36076/pmcr.2018/3/13 ◽

2019 ◽

pp. 13-31

Author(s):

Kevin Wong

Keyword(s):

Literature Review ◽

Fibrin Sealant ◽

Intracranial Hypotension ◽

Case Reports ◽

Case Series ◽

Retrospective Case ◽

Percutaneous Injection ◽

Retrospective Case Series ◽

Blood Patch

Background: Intracranial hypotension (IH) among patients with persistent cerebrospinal fluid (CSF) leakage remains a challenging problem. The majority of these cases resolve spontaneously with conservative measures. The customary treatment for IH is epidural blood patch (EBP). In some cases, CSF leaks can persist for months or even years despite multiple trials of EBP. To date, there are only a limited number of published studies documenting the percutaneous injection of fibrin sealant for treatment of IH refractory to conservative measures and EBP. Objective: Our objective was to perform a literature review and retrospective case series regarding patients who underwent percutaneous injection of fibrin sealant for treatment of refractory IH at our institution. Study Design: This case series used a singlecentered retrospective observational study design and literature review. Setting: Patients in this case series were treated at a community-based tertiary care medical center. Methods: Five consecutive patients with the diagnosis of IH refractory to conservative measures and EBP who underwent percutaneous patching with fibrin sealant were identified at our institution between January 1, 2000 and January 1, 2016. A retrospective chart review was performed and data including demographics, characteristics, interventions, clinical outcomes, and complications were collected. A critical review of the current literature regarding the percutaneous use of fibrin sealant for treatment of IH was conducted. Results: Four of the 5 patients (80%) experienced no further symptoms of IH and no adverse events were noted. One patient (20%) ultimately required surgical duroplasty. Review of the current literature showed a total of 2 prospective case series, 4 retrospective case series, and 11 case reports. Our present case series and literature review demonstrated that fibrin sealants were well-tolerated by most patients and associated with low incidences of complications and recurrence. Limitations: This study is limited by the small retrospective case series of 5 patients. Conclusions: Percutaneous injection of fibrin sealant may be considered in refractory cases of IH when repeated trials of EBP have persistently failed. It appears to be a highly effective, safe, and easy-touse alternative therapy for patients with refractory IH in an ambulatory setting. Our review of the literature revealed only studies with low quality of evidence, including case series and case reports. There is a substantial need for high-quality studies and clinical evidence to corroborate the efficacy and safety of this percutaneous technique. However, this ideal is very challenging because of the relative rarity and heterogeneous etiologies of cases. Keywords: Fibrin sealant, intracranial hypotension, CSF leak, epidural blood patch, orthostatic headache, refractory, quality of life, percutaneous

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Improved prognostic precision in uveal melanoma through a combined score of clinical stage and molecular prognostication

Ocular Oncology and Pathology ◽

10.1159/000520218 ◽

2021 ◽

Author(s):

Andrew W. Stacey ◽

Vaidehi S. Dedania ◽

Miguel Materin ◽

Hakan Demirci

Keyword(s):

Uveal Melanoma ◽

Risk Score ◽

Clinical Stage ◽

Case Series ◽

Clinical Staging ◽

Molecular Testing ◽

Total Risk ◽

Retrospective Case ◽

Simple Method ◽

Kaplan Meier

Introduction: Prognosis of uveal melanoma (UM) is assessed using clinical staging or molecular testing. Two modalities often used for prognostication are the American Joint Committee on Cancer (AJCC) staging and a tumor gene expression profile (GEP), the outcomes of which are often discordant. This paper discusses a Total Risk Score created to combine the discordant information from both sources. Methods: A retrospective case series was conducted of all patients presenting with UM over six years to two referral centers. Each tumor was classified using the AJCC and the GEP. A Total Risk Score was calculated for each patient using results from both AJCC and GEP. Kaplan-Meier analysis of metastasis free-survival was used to compare groups. Results: A total of 294 patients were included in the study. Kaplan-Meier estimates showed significant curve separation between individual AJCC and GEP risk groups. The combined Total Risk Score provided an accurate estimate of prognosis that incorporated results from both AJCC and GEP. Conclusions: Clinical staging and molecular prognostication of UM can be discordant. There is important information provided by each system that is not provided by the other. The Total Risk Score provides a simple method to combine information from both the AJCC stage and the GEP class in order to provide patients and care teams with a more complete understanding of metastatic risk.

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NEAR FATAL AMITRAZ: A NOT SO UNCOMMON POISONING

10.36106/gjra/5601517 ◽

2021 ◽

pp. 42-43

Author(s):

Rohan J Desai ◽

Prasad Ugargol

Keyword(s):

Mechanical Ventilation ◽

Respiratory Failure ◽

Clinical Features ◽

Case Series ◽

Agricultural Product ◽

Common Symptom ◽

Retrospective Case ◽

Case Series Study ◽

Cns Depression ◽

Series Study

Background: Amitraz is a pharmaceutical, veterinary, and agricultural product which is used worldwide to control ectoparasites in animals. Its widespread use has led to increased cases of poisoning in rural parts of India. Aim: To study the clinical features, complications, laboratory abnormalities and outcome of the patients with acute amitraz intoxication. Methodology: The study is a retrospective case series study conducted in HSK hospital between the period of Feb 2019 and May 2020. Results: A total of 11 patients were analysed and results revealed CNS depression and vomiting in 8 of those patients with 1 patient with respiratory failure requiring mechanical ventilation. Conclusion: Amitraz poisoning appears to be severe with CNS depression being the most common symptom. But most patients stabilise and recover quickly. Patients should be monitored for respiratory failure as it is a dreadful complication. Treatment is symptomatic as no antidote is available.

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Nivolumab and Ipilimumab in the Treatment of Metastatic Uveal Melanoma: A Single-Center Experience

Case Reports in Oncological Medicine ◽

10.1155/2019/3560640 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8 ◽

Cited By ~ 5

Author(s):

Vidhya Karivedu ◽

Ihab Eldessouki ◽

Ahmad Taftaf ◽

Zheng Zhu ◽

Abouelmagd Makramalla ◽

...

Keyword(s):

Partial Response ◽

Clinical Outcome ◽

Uveal Melanoma ◽

Stable Disease ◽

Checkpoint Inhibitors ◽

Evaluation Criteria ◽

Treatment Strategies ◽

Case Series ◽

Retrospective Case ◽

Study Results

Background. Metastatic uveal melanoma (MUM) is associated with a poor prognosis, with a median overall survival (OS) of 4–15 months. Despite new insights into the genetic and molecular background of MUM, satisfactory systemic treatment approaches are currently lacking. The study results of innovative treatment strategies are urgently needed. Patients and Methods. This was a retrospective case series of 8 patients with MUM managed at the University of Cincinnati between January 2015 and January 2018. The immune-related Response Evaluation Criteria in Solid Tumors (irRECIST) 1.1 criteria were used for patient evaluation, and magnetic resonance imaging was used for evaluation at treatment checkpoints. Objective. To assess the clinical outcome of patients with MUM treated with a combination of checkpoint inhibitors. Results. The series included eight patients, six men and two women, with MUM. Their median age at MUM diagnosis was 69 (range, 55–77) years. All patients were treated with ipilimumab and nivolumab combination along with transarterial chemoembolization (TACE), followed by nivolumab maintenance and monthly TACE procedures. The majority of patients had a partial response or stable disease. Two of the patients had partial response, while four others had stable disease. Two other patients experienced disease progression. Conclusion. We report the outcomes of eight patients with MUM treated with the combination of ipilimumab and nivolumab. We report the clinical outcome and toxicity associated with this treatment approach. Further studies are warranted to explore immunotherapy in MUM. These findings support the consideration of immunotherapy in MUM.

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Fascicular tachycardia in infancy and the use of verapamil: a case series and literature review

Archives of Disease in Childhood ◽

10.1136/archdischild-2018-315617 ◽

2019 ◽

Vol 104 (8) ◽

pp. 789-792 ◽

Cited By ~ 3

Author(s):

Jascha Kehr ◽

Alex Binfield ◽

Fraser Maxwell ◽

Tim Hornung ◽

Jonathan R Skinner

Keyword(s):

Literature Review ◽

Ventricular Dysfunction ◽

Case Series ◽

Older Children ◽

First Line ◽

Retrospective Case ◽

Extreme Caution ◽

Slow Infusion ◽

Long Acting ◽

Critical Literature

ObjectiveGuidelines state that verapamil is contraindicated in infants. This is based on reports of cardiovascular collapse and even death after rapid intravenous administration of verapamil in infants with supraventricular tachycardia (SVT). We wish to challenge this contraindication for the specific indication of verapamil sensitive ventricular tachycardia (VSVT) in infants.DesignRetrospective case series and critical literature review.SettingHospitals within New Zealand.PatientsWe present a series of three infants/young children with VSVT or ‘fascicular VT’.ResultsThree children aged between 8 days and 2 years presented with tachycardia 200–220 beats per minute with right bundle brunch block and superior axis. Adenosine failed to cardiovert and specialist review diagnosed VSVT. There were no features of cardiovascular shock. Verapamil was given as a slow infusion over 10–30 min (rather than as a push) and each successfully cardioverted without incident. Critical review of the literature reveals that cardiovascular collapses were associated with a rapid intravenous push in cardiovascularly compromised infants and/or infants given other long-acting antiarrhythmics prior to verapamil.ConclusionsVerapamil is specifically indicated for the treatment of fascicular VT, and for this indication should be used in infancy, as well as in older children, as first-line treatment or after failure of adenosine raises suspicion of the diagnosis. We outline how to distinguish this tachycardia from SVT and propose a strategy for the safe intravenous slow infusion of verapamil in children, noting that extreme caution is necessary with pre-existing ventricular dysfunction.

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