SARCOID CYSTIC LACRIMAL
Sun
6 papers
Survey of orbital tumors at a comprehensive cancer center in the United States.
Shinder R, Al-Zubidi N, Esmaeli B
Head Neck · 2011 May · PMID 20824811 · Publisher ↗
BACKGROUND: The purpose of this study was to evaluate the frequencies of various types of orbital lesions seen at a comprehensive cancer center in the United States. METHODS: In this retrospective case series, we reviewe...
BACKGROUND: The purpose of this study was to evaluate the frequencies of various types of orbital lesions seen at a comprehensive cancer center in the United States. METHODS: In this retrospective case series, we reviewed the medical records of 268 consecutive patients referred to our orbital oncology service for evaluation of an orbital mass between November 1998 and February 2009. Each orbital lesion was documented by CT and/or MRI, and in most cases diagnosis was established with a tissue biopsy. Patients who were seen for second opinions and had inadequate follow-up data were excluded, as were patients with thyroid eye disease or orbital hemorrhage. RESULTS: The study included 134 men and 134 women aged 1 to 89 years at diagnosis (median, 55 years). Follow-up ranged from 0.06 to 192 months (median, 15 months). Of the tumors, 171 (64%) were primary orbital, 69 (26%) were secondary orbital, and 28 (10%) were metastatic tumors. Lesion types were as follows: secondary orbital tumors, 69 (26%); lymphoproliferative lesions, 68 (25%); metastases, 28 (10%); epithelial lacrimal gland tumors, 27 (10%); inflammatory conditions, 21 (8%); vascular lesions, 20 (7%); mesenchymal tumors, 18 (7%); optic nerve and nerve sheath tumors, 7 (3%); peripheral nerve tumors, 3 (1%); histiocytic lesions, 3 (1%); cystic lesions, 3 (1%); and other lesions, 1 (<1%). The most common histopathologic diagnoses were lymphoma, 50 cases (19%); orbital extension of sinus tumor, 25 (9%); lacrimal gland adenoid cystic carcinoma, 18 (7%); cavernous hemangioma, 15 (6%); orbital extension of brain tumor, 14 (5%); idiopathic orbital inflammation, 14 (5%); plasmacytoma, 8 (3%); reactive lymphoid hyperplasia, 7 (3%); metastatic breast cancer, 7 (3%); orbital extension of ocular adnexal basal cell carcinoma, 7 (3%); orbital extension of ocular adnexal melanoma, 6 (2%), rhabdomyosarcoma, 6 (2%); metastatic gastrointestinal cancer, 5 (2%); sarcoidosis, 5 (2%); and other less common lesions. Forty-two lesions (16%) were intraconal, and 226 (84%) were extraconal. There were 169 (63%) malignant tumors and 99 (37%) were benign tumors. The rate of malignant lesions was 65% in children and 63% in adults (≥18 years). Malignant conditions encountered at a higher rate than previously reported included lymphoma (19% vs 8% to 13%), secondary orbital tumors (26% vs 13% to 20%), orbital metastases (10% vs 2% to 7%), and malignant epithelial lacrimal gland tumors (9% vs 2% to 3%). CONCLUSION: Our findings highlight the distinctive nature of the orbital oncology experience at a comprehensive cancer center. We found higher than previously reported rates of malignant tumors (63% of all tumors), particularly secondary tumors, malignant epithelial lacrimal gland tumors, and orbital metastases.
[Clinical analysis of sarcoidosis of ocular adnexa].
Wei CH, Qian J, Yao YQ … +2 more , Yuan YF, Wu HX
Zhonghua Yan Ke Za Zhi · 2010 Jan · PMID 20388319
OBJECTIVE: To study the diagnosis and treatment of 17 patients with sarcoidosis in ocular adnexa. METHODS: The clinical data of 17 cases with sarcoidosis in ocular adnexa treated during 1993 and 2008 were retrospectively...
OBJECTIVE: To study the diagnosis and treatment of 17 patients with sarcoidosis in ocular adnexa. METHODS: The clinical data of 17 cases with sarcoidosis in ocular adnexa treated during 1993 and 2008 were retrospectively analyzed. All patients underwent surgical treatment, and the diagnosis was proven histopathologically. RESULTS: Among the 17 cases, 4 were male, and 13 were female. The patients' age ranged from 15 to 70 years, with a mean of 46.9 years. The lesions were located at the orbit (8 cases), lacrimal grand (5 cases) and eyelids (4 cases). Fourteen cases complained of the presence of a local mass, 2 cases complained of exophthalmos and 1 swelling of eyelids. Concurrent systemic sarcoidosis was present in 7 cases. Three cases coincided with lung sarcoidosis, 3 cases with uveitis and 1 case with dermatopathy. Angiotensin converting enzyme analysis was performed in 6 cases; 4 of them were elevated. Computer tomography was performed in 12 cases; in 11 cases it presented as moderate density parenchymatous mass, and in the remaining one it presented as hypodensity cystic mass. B scan of 5 cases showed hypoechoic parenchymatous homogeneous mass. None of 14 cases relapsed after 1 to 15 years follow-up. CONCLUSIONS: Ocular adnexal sarcoidosis usually presents as local mass and it should be included in the differential diagnosis of orbital and ocular adnexal lesions. Excision of localized mass alone could achieve satisfactory outcomes for isolated lesions, while for diffuse or systematic lesions, corticosteroid treatment should be prescribed routinely.
Lacrimal fossa lesions: pictorial review of CT and MRI features.
Vaidhyanath R, Kirke R, Brown L … +1 more , Sampath R
Orbit · 2008 · PMID 19085295 · Publisher ↗
A wide range of disease process involve the lacrimal gland/fossa. In this pictorial review, we use histology-proven cases to illustrate conditions that affect the lacrimal gland/fossa. CT and MRI features of neoplastic,...
A wide range of disease process involve the lacrimal gland/fossa. In this pictorial review, we use histology-proven cases to illustrate conditions that affect the lacrimal gland/fossa. CT and MRI features of neoplastic, inflammatory, infiltrative, and developmental conditions are discussed.
[Clinical presentation, differential diagnosis and treatment of lacrimal gland tumours].
Hajda M, Korányi K, Salomváry B … +1 more , Bajcsay A
Magy Onkol · 2005 · PMID 15902337
PURPOSE: We describe the tumours occurring in the lacrimal gland fossa region, the important symptoms and the principles of the therapy. METHODS: We surveyed the patients observed and operated at the National Institute o...
PURPOSE: We describe the tumours occurring in the lacrimal gland fossa region, the important symptoms and the principles of the therapy. METHODS: We surveyed the patients observed and operated at the National Institute of Neurosurgery, Budapest, Hungary. RESULTS: Space-occupying lesions of lacrimal gland fossa are: 1. Epithelial lacrimal gland tumours, which may be benign or malignant (benign pleomorphic adenoma, malignant pleomorphic adenocarcinoma, adenoid cystic carcinoma, other carcinomas). 2. Lymphoproliferative tumours (lymphoma, leukaemia, Hodgkin's disease, lymphosarcoma, plasmocytoma). 3. Pseudotumours (chronic inflammation, granuloma, sarcoidosis, reactive lymphoid hyperplasia). 4. Other tumours (dermoid cyst, haemangioma, neurinoma, haemangiopericytoma, metastatic tumour). In our Institute, 42% of the tumours of the lacrimal fossa was epithelial, 50% was lymphoid or pseudotumour, and 8% other tumours. Of the 59 primary epithelial tumours 62.7% was benign and 37.3% was malignant. The differential diagnosis and management are based on the clinical presentations, imaging studies and histological examination. CONCLUSIONS: Pleomorphic adenomas of the lacrimal gland should be diagnosed on radiological and clinical evidence, and biopsy avoided to prevent the recurrences and malignant transformation. The prognosis of pleomorphic adenomas depends on the early diagnosis and radical surgical excision of the lesion. In cases of suspected malignant epithelial tumours, lymphomas and pseudotumours, biopsy is indicated for the choice of appropriate treatment.
[A case of sarcoidosis with primary acute pulmonary cavitation].
Yoshii C, Imai M, Obata H … +3 more , Nikaido Y, Nagata N, Kido M
Nihon Kyobu Shikkan Gakkai Zasshi · 1992 Apr · PMID 1405094
A 23-year-old man was admitted to our hospital on June 24, 1991, because of worsening chest X-ray findings of sarcoidosis. In August 1990, he was referred to our outpatient office, because of BHL and nodular lesions on c...
A 23-year-old man was admitted to our hospital on June 24, 1991, because of worsening chest X-ray findings of sarcoidosis. In August 1990, he was referred to our outpatient office, because of BHL and nodular lesions on chest X-ray film performed at his company 4 months earlier. At that time, serum ACE was elevated to 34.0 IU/l, and Ga scintigraphy showed abnormal uptake in bilateral lacrimal and salivary glands, mediastinal and hilar lymph nodes, and in the lung fields. TBLB specimen showed noncaseating epithelioid granuloma with giant cells and negative stains for acid-fast bacilli. Although it was planned to follow this patient without medication, he did not return to our outpatient department. In June 1991, because of worsening of lesions in the lung at annual checkup at his company, he was referred and admitted for steroid therapy. Chest X-ray film on admission showed BHL, multiple nodular lesions in both lung fields, and bullous change in the left upper lobe. Chest CT on admission showed three cavitating lesions within preexisting nodules. PPD skin test was negative, and sputum smears and cultures were repeatedly negative for pyogenic bacteria and acid-fast bacilli. Therapy was initiated with prednisolone 30 mg daily. Four months later, there was marked resolution of BHL and nodular lesions, and the cavitating lesions were no longer visible on chest X-ray film. From the clinical and radiological observations, it is concluded that the cavitating lesions in the present case were primary acute pulmonary cavitation in sarcoidosis, distinct from infection, bullae, or cystic bronchiectasis which are seen in the chronic and fibrotic stages of sarcoidosis.
Management of lacrimal fossa masses.
Osguthorpe JD, Weisman RA, Tapert MJ
Arch Otolaryngol Head Neck Surg · 1986 Feb · PMID 3002407 · Publisher ↗
Mass lesions of the lacrimal fossa are evenly divided between epithelial and nonepithelial diseases. Nonepithelial lesions include pseudotumor, benign lymphoid hyperplasia, lymphoma, and sarcoid. Epithelial lesions are e...
Mass lesions of the lacrimal fossa are evenly divided between epithelial and nonepithelial diseases. Nonepithelial lesions include pseudotumor, benign lymphoid hyperplasia, lymphoma, and sarcoid. Epithelial lesions are evenly divided between benign and malignant neoplasia, and are similar to those of the salivary glands. Benign mixed tumors compose 25% of lacrimal gland tumors, and are very slow-growing, painless lesions that should be removed en bloc without a biopsy to avoid seeding the orbit. Adenoid cystic and malignant mixed carcinomas are the most common malignancies, and present with rapid growth and pain. These require incisional biopsy to establish the diagnosis, and then a radical exenteration and postoperative radiation therapy.
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