Rubinstein-Taybi syndrome (RTS) is a rare congenital neurodevelopmental disorder associated with several ocular and lacrimal anomalies. A 40-year-old female patient with RTS presented with persistent right-sided epiphora...Rubinstein-Taybi syndrome (RTS) is a rare congenital neurodevelopmental disorder associated with several ocular and lacrimal anomalies. A 40-year-old female patient with RTS presented with persistent right-sided epiphora following an earlier unsuccessful endoscopic dacryocystorhinostomy performed elsewhere. The patient underwent revision external dacryocystorhinostomy with fistulectomy and intubation. Intraoperatively, a focal polypoidal lacrimal sac lesion was noted, and histological analysis revealed significant immunoglobulin G4 (IgG4)-plasma cell infiltration. However, the diagnostic criteria for IgG4-related ophthalmic disease were not fulfilled. The revision external surgery was anatomically and functionally successful. To the best of the authors' knowledge, this is the first report of IgG4-plasma cell infiltration in the lacrimal apparatus of a patient with RTS.
PURPOSE: In silicone sling frontalis suspension surgery, the sling is secured by passing both ends through a tight sleeve. Slippage of the silicone sling through the sleeve is likely a major reason for surgical failure....PURPOSE: In silicone sling frontalis suspension surgery, the sling is secured by passing both ends through a tight sleeve. Slippage of the silicone sling through the sleeve is likely a major reason for surgical failure. This ex vivo study compared different securing methods to improve the security of the sling in the sleeve. METHODS: This quantitative laboratory study compared 6 methods of securing the sling and sleeve to the control: 1) sutures to join the sleeve and sling, 2) 2-throw and 3) 3-throw square knots with the sling, 4) ligaclips, 5) cyanoacrylate surgical glue, and 6) a heat-shrink polyolefin sleeve. Tensile strength in Newtons (N) was measured to determine the force required to either initiate tail slippage or cause complete breakage of the silicone sling. RESULTS: The securing methods, ranked by tensile strength, were: 3-throw square knot (4.3 N ±0.3), 2-throw square knot (3.7 N ±0.4), sutures (2.7 N ±0.5), ligaclips (1.3 N ±0.3), heat-shrink (1.1 N ±0.4), glue (0.6 N ±0.1), and control (0.2 N ±0.0). All methods, except glue, were significantly more effective than the control group. CONCLUSIONS: Multiple methods can greatly improve the security of the sling within the sleeve in these laboratory tests. However, further in vivo exploration is needed to assess other factors such as biocompatibility, risk of extrusion, adjustability, and prominence under the brow. The aim is to develop a quick and easy method to apply while allowing for safe removal or loosening to adjust lid height without introducing additional risks.
Extensive periorbital burns pose profound reconstructive challenges, particularly those that leave a composite orbitocranial defect lacking adequate local tissue for coverage. The authors report a case of a 40-year-old m...Extensive periorbital burns pose profound reconstructive challenges, particularly those that leave a composite orbitocranial defect lacking adequate local tissue for coverage. The authors report a case of a 40-year-old man who suffered severe facial soft-tissue burn injury, bilateral Roper-Hall grade IV ocular injury, and progressive periorbital necrosis who ultimately required bilateral orbital exenteration and multidisciplinary reconstructive efforts. To the authors' knowledge, this is the first description of a single-stage latissimus dorsi myocutaneous free flap reconstruction after bilateral orbital exenteration following extensive periorbital thermal burns and affirms the reliability of the latissimus dorsi myocutaneous flap for orbitocranial defect repair.
PURPOSE: To introduce a novel septal ballooning technique for orbital septum dissection during surgery. METHODS: The study comprised 18 patients (30 eyes) who underwent septal ballooning at Gachon Gil Hospital, Incheon,...PURPOSE: To introduce a novel septal ballooning technique for orbital septum dissection during surgery. METHODS: The study comprised 18 patients (30 eyes) who underwent septal ballooning at Gachon Gil Hospital, Incheon, South Korea, between September 2023 and January 2024. The technique involves injecting room air beneath the orbital septum, a pneumodissection, to separate it from surrounding structures, enhancing visualization during dissection. Data collected included patient demographics, preoperative diagnoses, and postoperative complications. Intraoperative levator aponeurosis injury and postoperative complications were reported. RESULTS: Septal ballooning was successfully performed on all patients, with no intraoperative injuries to the levator aponeurosis. Postoperative CT imaging revealed minor orbital emphysema in 3 cases (4 eyes), which resolved spontaneously without intervention. There were no reports of significant complications such as visual sequelae or infections. The technique facilitated clear identification and dissection of the orbital septum, reducing intraoperative difficulty. CONCLUSIONS: The septal ballooning technique is an effective alternative method for orbital septum dissection, offering improved anatomical visualization and reduced intraoperative complexity. This method enhances the precision and safety of procedures involving the orbital septum and is a valuable addition to surgical practice.
This case describes the clinical course and management of a conjunctival inflammatory myofibroblastic tumor with a transforming growth factor::ROS proto-oncogene 1 fusion in a 33-year-old woman presenting with a progress...This case describes the clinical course and management of a conjunctival inflammatory myofibroblastic tumor with a transforming growth factor::ROS proto-oncogene 1 fusion in a 33-year-old woman presenting with a progressively enlarging subconjunctival mass. Diagnosis was confirmed by biopsy and RNA next-generation sequencing. Treatment with the tyrosine kinase inhibitor crizotinib led to complete tumor resolution; however, therapy was discontinued due to a sarcoid-like granulomatous reaction. Visual acuity remained stable at 20/20 throughout, and no recurrence was observed. This case highlights the diagnostic challenges of conjunctival inflammatory myofibroblastic tumor, the therapeutic potential of targeted kinase inhibition, and the critical role of genomic profiling in guiding personalized treatment for rare ocular tumors such as inflammatory myofibroblastic tumor.
PURPOSE: To compare surgical outcomes and complications between Crawford and Nunchaku-style tubes in dacryoendoscopy-guided silicone intubation for primary acquired nasolacrimal duct obstruction. METHODS: The authors ret...PURPOSE: To compare surgical outcomes and complications between Crawford and Nunchaku-style tubes in dacryoendoscopy-guided silicone intubation for primary acquired nasolacrimal duct obstruction. METHODS: The authors retrospectively reviewed 24 consecutive patients with bilateral primary acquired nasolacrimal duct obstruction who underwent dacryoendoscopy-guided silicone intubation with >6 months of follow-up. Crawford and Nunchaku-style tubes were used for OD and OS, respectively, and both were removed 6 months postoperatively. Surgical success was assessed at 9 months based on irrigation patency and epiphora relief. Complications, including tube extrusion and punctal slit, were monitored. The authors compared success rates and complications between groups and analyzed extrusion impact and punctal slit on surgical outcomes, and risk factors for punctal slit in the Nunchaku group. RESULTS: Surgical success rates were 83.3% and 88.9% in the Crawford and Nunchaku groups, respectively ( p = 1.000). Tube extrusion was more common in the Crawford group (29.2% vs. 0.0%, p = 0.009), whereas punctal slit was more frequent in the Nunchaku group (41.7% vs. 0.0%, p < 0.001). Neither tube extrusion nor punctal slit significantly affected surgical outcomes ( p = 1.000 and p = 0.477, respectively). Diffuse obstruction observed on dacryoendoscopy was associated with a higher risk of punctal slit in the Nunchaku group, though not statistically significant (odds ratio = 6.000, p = 0.071). CONCLUSIONS: Crawford and Nunchaku-style tubes showed similar success rates. Nunchaku-style tubes reduce the need for nasal manipulation and extrusion risk but increase punctal slit risk. Clinicians should consider these differences when choosing tube type and optimizing surgical techniques.
An 84-year-old female with a history of bilateral congenital ptosis presented with pain in the OD. The patient had undergone bilateral frontalis flap and levator advancement for decompensated congenital ptosis 18 months...An 84-year-old female with a history of bilateral congenital ptosis presented with pain in the OD. The patient had undergone bilateral frontalis flap and levator advancement for decompensated congenital ptosis 18 months prior. On examination, the patient demonstrated significant retraction and contour abnormalities of the right upper eyelid. Slit lamp exam revealed superficial punctate keratitis of the OD. The patient underwent ptosis revision of the right upper eyelid, which revealed scarring of the orbital septum to the advanced levator muscle and a severely fibrotic levator muscle. Following revision of the orbital septum and levator, the patient demonstrated significant improvement in eyelid closure with minimal residual ptosis, recurrent eyelash ptosis, and improved ocular surface comfort.
PURPOSE: To describe the course of the superficial temporal artery (STA) and identify the optimal location for temporal artery biopsy when a pulse cannot be reliably palpated. METHODS: In this anatomical study, the arter...PURPOSE: To describe the course of the superficial temporal artery (STA) and identify the optimal location for temporal artery biopsy when a pulse cannot be reliably palpated. METHODS: In this anatomical study, the arterial systems of 12 fresh adult cadaver heads were filled with red neoprene latex to highlight the STA. Coronal incisions starting at the root of the auricular helix and extended 80 mm superiorly were made bilaterally. The primary outcome was the probability of the STA being encountered at each location on a standardized, superimposed 50 × 50 mm grid. Secondary outcomes included degree of declination from the incision line, distance at which the vessel crossed the incision, presence of frontal/parietal bifurcation, presence of branches, visibility of the temporal branch of the facial nerve, and vessel caliber. Means, standard deviations, and ranges were used to describe the data. RESULTS: In all specimens analyzed, the STA crossed the coronal incision line within 45 mm of the helix root. The STA was found within the same 5 × 5 mm location, 10 to 15 mm cranial to the root of the helix, and 5 to 10 mm anterior to the incision in 68.4% of specimens. In the remaining specimens, a portion of the STA was found within 7 mm of this location. CONCLUSION: Especially in cases where the STA is nonpalpable, care must be taken to avoid iatrogenic injury to the facial nerve during temporal artery biopsy. Surgeons should recognize that the STA can be reliably encountered with an incision beginning 5 mm anterior and 5 mm cranial to the helix root, carried 40 mm in the posterior and cranial direction, 30 degrees declined from the coronal plane.
Removal of an orbital cavernous venous malformation in a 39-year-old white female resulted in a significant intraoperative sectoral mydriasis. White fascicles were recorded as running into the mass at surgery, and one of...Removal of an orbital cavernous venous malformation in a 39-year-old white female resulted in a significant intraoperative sectoral mydriasis. White fascicles were recorded as running into the mass at surgery, and one of these was confirmed histologically to be peripheral nerve within the capsule of a markedly fibrous orbital cavernous venous malformation. Most efferent pupillary anomalies after orbital surgery are probably due to ischemic or tractional neuropraxia, but the resected nerve raises the possibility of unplanned excision of a few fascicles of the postganglionic (parasympathetic) short ciliary nerves.
PURPOSE: Unrefined eyelid margin is a known complication following the second-stage modified Hughes eyelid reconstruction. Lateral canthal malposition, phimosis, or eyelid laxity can occur when the tarsoconjunctival flap...PURPOSE: Unrefined eyelid margin is a known complication following the second-stage modified Hughes eyelid reconstruction. Lateral canthal malposition, phimosis, or eyelid laxity can occur when the tarsoconjunctival flap extends to cover the defects in the inferior crus of the lateral canthus. This study presents a novel surgical technique that prevents lower eyelid margin distortions, lower eyelid laxity, and lateral canthal complications after the second-stage modified Hughes reconstruction. METHODS: A retrospective review of patients who underwent second-stage modified Hughes reconstructions with a lateralized tarsoconjunctival rotational flap from July 2021 to August 2024 was performed. The study outcomes included postreconstruction complications, such as eyelid malposition, eyelid margin changes, lateral canthus distortions, flap dehiscence, and eyelid-related complaints. Postoperative photographs were reviewed to evaluate eyelid position, flap, and lateral canthus contour. RESULTS: Nineteen patients underwent repair using a tarsoconjunctival rotational flap as part of the second-stage modified Hughes reconstruction. The average time between the first and second-stage modified Hughes reconstruction was 61.5 ± 10.6 days. Postoperative photos showed no cases of hyperemic eyelid margins, hypertrophic eyelid margins, inferior canthal tendon laxity, lateral canthus phimosis, lateral canthus imbrications, flap dehiscence, or lateral canthal irritations. One patient complained of persistent lower eyelid irritation and discharge, and 1 patient had persistent edema, both of which resolved at the last follow-up. CONCLUSION: The lateralized tarsoconjunctival rotational flap has favorable surgical outcomes in the second-stage modified Hughes reconstruction of lower eyelid defects.
PURPOSE: To analyze the relationship between traditional bibliometric measures and Altmetric Scores for articles on thyroid eye disease, examining their scientific and social media impact from 2010 to 2024. METHODS: The...PURPOSE: To analyze the relationship between traditional bibliometric measures and Altmetric Scores for articles on thyroid eye disease, examining their scientific and social media impact from 2010 to 2024. METHODS: The authors analyzed the 100 most-cited articles on thyroid eye disease from the Web of Science Core Collection, comparing traditional citation metrics with Altmetric Attention Scores. Statistical analyses included Spearman correlation, temporal trend analysis, and comparison of impact patterns across journals and publication years. RESULTS: Among the top 100 cited articles, the authors found a moderate positive correlation between citations and Altmetric Scores ( r = 0.350, p = 0.002). Only 8% of articles achieved high impact in both metrics (>Q3). The median citation count was 40 (interquartile range: 32-59; range: 26-531), while the median Altmetric Score was 3 (interquartile range: 1-10; range: 1-546). Recent articles (2020-2024) showed significantly higher Altmetric Scores compared with earlier periods (median: 11 vs. 1, p < 0.0001). Open access articles demonstrated higher impact in both metrics compared with subscription-based articles. CONCLUSION: Traditional citation metrics and social media impact measures capture different aspects of research influence in thyroid eye disease literature. The emergence of high-impact therapeutic studies, particularly regarding teprotumumab, demonstrates how breakthrough research can achieve substantial impact across both traditional and alternative metrics. Given the increasing role of social media in research dissemination and patient education, clinicians should consider both traditional and alternative metrics when evaluating research impact and should be prepared to discuss studies that achieve high social media engagement with patients.
Proper reconstruction of the lower eyelids is essential to preserve their function and aesthetic integrity. However, there are limited studies on lower eyelid reconstruction in specific patient populations without availa...Proper reconstruction of the lower eyelids is essential to preserve their function and aesthetic integrity. However, there are limited studies on lower eyelid reconstruction in specific patient populations without available donor sites, such as pediatric patients and those with common skin lesions, severe facial scars, and recurrent lower eyelid tumors. This study aims to analyze the results of a novel technique, the orbicularis oculi myoperiosteal flap, in a challenging case: a pediatric patient with xeroderma pigmentosum who lacks skin laxity and has limited tissue availability. Based on this single case, the proposed orbicularis oculi myoperiosteal flap appears to be a promising technique for lower eyelid reconstruction in challenging scenarios, offering proper lid function and acceptable aesthetic results without significant donor-site morbidity in a single stage. Therefore, the orbicularis oculi myoperiosteal flap should be considered an essential technique in the armamentarium of reconstructive surgeons.
A retrospective case series was performed to describe a transorbital endoscopic approach to the superior orbital apex. The surgical technique involved an extended lid crease incision and subperiosteal dissection along th...A retrospective case series was performed to describe a transorbital endoscopic approach to the superior orbital apex. The surgical technique involved an extended lid crease incision and subperiosteal dissection along the orbital roof. Three patients were identified for inclusion (a 9-year-old male, a 21-year-old male, and a 55-year-old female). Follow-up time ranged from 10 months to 2 years. Procedural indications included biopsy or debulking of orbital and/or dural tissue for antineutrophilic cytoplasmic antibody vasculitis with hypertrophic pachymeningitis, orbital myxoma, and Langerhans cell histiocytosis. No intraoperative complications were encountered. All patients developed postoperative ptosis and upgaze limitation, which persisted in 1 patient at 12-month follow-up. There were no instances of a permanent sensory deficit or cerebrospinal fluid leak. The transorbital approach to the superior apex under endoscopic guidance represents a reasonable alternative to a lateral orbitotomy or craniotomy for the biopsy of orbital masses.
Orbital arteriovenous malformations (AVMs) are rare vascular anomalies that typically progress gradually. This case presents an unusual acute presentation of orbital AVM causing angle-closure glaucoma in a 48-year-old Ko...Orbital arteriovenous malformations (AVMs) are rare vascular anomalies that typically progress gradually. This case presents an unusual acute presentation of orbital AVM causing angle-closure glaucoma in a 48-year-old Korean male. He presented with severe left ocular pain, proptosis, and vision loss for 2 days. Examination revealed elevated intraocular pressure associated with crystalline lens subluxation into the anterior chamber and restricted extraocular movement. Imaging studies confirmed an intraorbital AVM. Urgent endovascular embolization using Onyx was performed, followed by phacoemulsification with scleral-fixated intraocular lens implantation. His condition gradually improved, with the resolution of strabismus and normalization of intraocular pressure. Long-term follow-up 6 years postintervention demonstrated stable visual acuity, normal intraocular pressure, and no AVM recurrence. This case underscores the importance of considering orbital AVMs in acute unilateral proptosis with angle-closure glaucoma. It emphasizes the possible coincidence of AVM and lens-induced angle closure and the importance of early diagnosis and intervention for optimal outcomes.
Shah SA, Chandraparnik P, Choi S
… +21 more, Amarikwa L, Guniganti R, Walsh HL, Rubio RH, Linaburg T, Meyer E, Reem K, Sears C, Goldin M, Kinde B, Dosiou C, Malik A, Mawn L, Shinder R, Wester S, Rootman D, Cockerham K, Tamhankar M, Couch S, Harrison A, Kossler AL
PURPOSE: To evaluate the efficacy and safety of teprotumumab for the treatment of thyroid eye disease in geriatric patients. METHODS: This was a multicenter cohort study of patients aged 75 and older, treated between Feb...PURPOSE: To evaluate the efficacy and safety of teprotumumab for the treatment of thyroid eye disease in geriatric patients. METHODS: This was a multicenter cohort study of patients aged 75 and older, treated between February 2020 and September 2023 across 10 tertiary institutions. Patients were included if they had moderate-to-severe thyroid eye disease and at least 1 infusion of teprotumumab. Efficacy outcome measures included improvement in clinical activity score, proptosis, and Gorman diplopia score. Safety outcome measures included teprotumumab-related adverse event (TAE) incidence, onset, and severity. RESULTS: Fifty patients (40 females, 10 males), average age of 79.2 years, were evaluated. Patients received an average of 6.9 infusions, with 34.0% (17/50) discontinuing treatment due to TAEs. Mean baseline clinical activity score was 4.0 ± 1.6, with a mean reduction of 4.0 ± 1.1. Proptosis improved by ≥2 mm in 86.0% (43/50) of patients, with a mean reduction of 4.24 mm. Of patients with baseline diplopia, 42.9% (18/42) experienced an improvement in Gorman diplopia score. Proptosis regression occurred in 62.5% (15/24) of patients at 2.5 years, and 27.9% (12/43) experienced thyroid eye disease reactivation on average 49.8 weeks posttreatment completion. TAEs were reported by 78.0% (39/50) of patients, with 30% (15/46) experiencing moderate TAEs and 14% (7/50) severe TAEs. The most common TAEs were muscle cramps (42.0%, 21/50), hearing impairment (38.0%, 19/46), and hyperglycemia (36.0%, 18/46). CONCLUSIONS: Teprotumumab is effective in reducing clinical activity score and proptosis in geriatric thyroid eye disease patients with short-term follow-up; however, high rates of adverse events, reactivation, and proptosis regression over time warrant extreme caution and selective use in this population.
This article presents the rare occurrence of a trichilemmal cyst in the orbit of a 69-year-old female patient, who presented with a headache of acute onset and relative unilateral proptosis of the left eye. CT scan showe...This article presents the rare occurrence of a trichilemmal cyst in the orbit of a 69-year-old female patient, who presented with a headache of acute onset and relative unilateral proptosis of the left eye. CT scan showed a cystic, well-demarcated, round hypodense lesion, with spotted calcification. Surgery was performed for the extraction and analysis of the lesion, which showed typical histological findings of a trichilemmal tumor. This case represents the only one reported in the literature, to the best of the authors' knowledge. An atypical localization for this kind of tumor that usually arises from zones with an abundance of hair follicles.
PURPOSE: To examine the position of the lower marginal arterial arcade (LMA) along the lower tarsal plate in microscopic specimens, particularly its relationship to anatomical landmarks. METHODS: Central sagittal section...PURPOSE: To examine the position of the lower marginal arterial arcade (LMA) along the lower tarsal plate in microscopic specimens, particularly its relationship to anatomical landmarks. METHODS: Central sagittal sections of 27 lower eyelids (12 right, 10 left) from 15 Japanese cadavers (8 males, 7 females; aged 38-88 years, mean 70.5 years) were histologically examined. Specimens were fixed in 10% formalin and stained with Masson's trichrome. Measurements included the height of the lower tarsal plate and the distance from the lower tarsal edge and the lower eyelid margin to the LMA. Differences related to age (younger group: 38-61 years; older group: 73-88 years), gender, and laterality were analyzed. RESULTS: Lower tarsal height was significantly greater in females and tended to be larger on the left side. The distance from the lower tarsal edge to the LMA showed no significant differences by age, gender, or laterality. The distance from the lower eyelid margin to the LMA was similar across age and gender groups, but was significantly greater on the left side. CONCLUSION: The position of the LMA relative to the lower tarsal edge and the lower eyelid margin was established. When the lower edge of the tarsal plate is visible, the LMA is estimated to be approximately 1.5 mm superior; conversely, when the LMA is identified, the eyelid margin can be assumed to be about 3-4 mm superior to the LMA. These findings describe the LMA location and will assist in safe and reliable lower eyelid surgery.
Carotid-cavernous fistulas (CCF) are indirect or direct vascular shunts between vessels of the cavernous sinus and the carotid artery. While indirect CCFs have high rates of spontaneous resolution, direct CCF cases can r...Carotid-cavernous fistulas (CCF) are indirect or direct vascular shunts between vessels of the cavernous sinus and the carotid artery. While indirect CCFs have high rates of spontaneous resolution, direct CCF cases can result in significant orbital and neurological sequelae. This case describes a 75-year-old male patient presenting with acute subarachnoid hemorrhage secondary to a Barrow type-D CCF. Digital subtraction angiography revealed dual arterial supply of the CCF from both the left and right internal carotid artery. Transvenous access for coiling could not be achieved due to vessel tortuosity. Thus, the authors used an endoscopic transorbital approach to directly puncture the cavernous sinus through the superior orbital fissure. This approach allowed for direct visualization of the lateral cavernous sinus and enabled endovascular maneuvrability and coiling. There was a reduction but residual flow post CCF coiling due to microcatheter kickback preventing posterior embolization. Persistent CCF necessitated a craniotomy to allow sufficient access for complete obliteration. At 6-week postcoiling, there was resolution of proptosis and full extraocular movements. This approach has been described in cadaveric studies, with this case demonstrating the first application of this technique in vivo for CCF.
PURPOSE: The primary objective was to investigate the trends in orbital exenteration rates at a large tertiary care center, particularly in the context of recent advancements in immunotherapy, targeted agents, and globe-...PURPOSE: The primary objective was to investigate the trends in orbital exenteration rates at a large tertiary care center, particularly in the context of recent advancements in immunotherapy, targeted agents, and globe-sparing surgical techniques, which have significantly impacted patient management. METHODS: The authors conducted a retrospective cohort study at the University of Miami. Patients who underwent orbital exenterations from 2011 to 2024 were identified by obtaining surgical coding data via institutional data brokers and validated through a rigorous surgical chart review. The authors used Poisson regression with robust standard errors to compare incidence trends, using the Florida state population as an offset. The analyses compared 2011 to 2017 with 2018 to 2024 and examined year-by-year variation, ensuring a robust and reliable study. RESULTS: A total of 179 exenteration cases were identified. Compared with 2011 to 2017, total exenterations decreased by 39% in 2018 to 2024 (incidence rate ratio [IRR] = 0.61; p = 0.004). Significant declines were also observed from 2018 to 2024 for cutaneous squamous cell carcinoma (IRR = 0.49; p = 0.023) and ocular surface squamous neoplasia (IRR = 0.17; p = 0.002), while sebaceous gland carcinoma increased (IRR = 2.94; p = 0.015). Year-over-year analysis estimated a 3.9% annual decrease in total exenterations. CONCLUSIONS: This study revealed a significant decline in total orbital exenterations from 2018 to 2024 and diagnosis-specific declines in exenterations for cutaneous squamous cell carcinoma and ocular surface squamous neoplasia compared with 2011 to 2017. This trend coincides with the introduction of Programmed Cell Death Protein 1 (PD-1) inhibitors and other immunotherapies, first approved by the United States Food & Drug Administration in 2018, and suggests they may have contributed to the observed decline. These findings reflect shifting oncologic treatment paradigms and underscore important implications for surgical training and resource planning.
Solitary fibrous tumor, formerly also referred to as hemangiopericytoma, is a fibroblastic mesenchymal neoplasm of the orbit that rarely metastasizes but has a propensity for local recurrence. The authors describe 5 case...Solitary fibrous tumor, formerly also referred to as hemangiopericytoma, is a fibroblastic mesenchymal neoplasm of the orbit that rarely metastasizes but has a propensity for local recurrence. The authors describe 5 cases of orbital solitary fibrous tumors that were treated with radiation. In 3 patients, radiation therapy was given in the neoadjuvant setting prior to surgery. In the remaining 2 patients, radiation was used palliatively in patients who declined surgery. In 4 of 5 cases, a measurable reduction in the size of the orbital mass was observed in response to radiation therapy; however, long-term adverse effects of radiation may not yet be evident, given the relatively short follow-up period for some of the patients in this report.