A 61-year-old man with no history of malignancy presented with a rapidly expanding left periorbital mass, first noticed one month prior to presentation. The mass was firm, and a pus-like discharge drained spontaneously from the center of the lesion. A biopsy was performed, and histopathology confirmed squamous cell carcinoma. Systemic evaluation revealed that the patient had a primary esophageal squamous cell carcinoma with multiple metastases. The prognosis of orbital metastasis is generally poor, and this patient expired after one month of conservative treatment.
Abscess/diagnosis ; Biopsy ; Carcinoma, Squamous Cell/*diagnosis/*secondary ; Diagnosis, Differential ; Esophageal Neoplasms/*pathology ; Fatal Outcome ; Humans ; Male ; Middle Aged ; Orbital Diseases/diagnosis ; Orbital Neoplasms/*diagnosis/*secondary

A subconjunctival orbital fat prolapse is frequently confused with a dermolipoma clinically. These two entities have similar clinical appearances, but are clearly distinct. The clinical features, differential diagnosis, and treatment modalities of subconjunctival orbital fat prolapse and dermolipoma are discussed.
Adipose Tissue/*pathology ; Adult ; Female ; Humans ; Lipoma/*diagnosis ; Male ; Middle Aged ; Orbit/pathology/radiography ; Orbital Diseases/*diagnosis ; Orbital Neoplasms/*diagnosis ; Prolapse

A subconjunctival orbital fat prolapse is frequently confused with a dermolipoma clinically. These two entities have similar clinical appearances, but are clearly distinct. The clinical features, differential diagnosis, and treatment modalities of subconjunctival orbital fat prolapse and dermolipoma are discussed.
Adipose Tissue/*pathology ; Adult ; Female ; Humans ; Lipoma/*diagnosis ; Male ; Middle Aged ; Orbit/pathology/radiography ; Orbital Diseases/*diagnosis ; Orbital Neoplasms/*diagnosis ; Prolapse

Carcinoma, Squamous Cell ; diagnosis ; surgery ; Diagnosis, Differential ; Eye Evisceration ; Humans ; Male ; Middle Aged ; Orbital Neoplasms ; diagnosis ; surgery ; Ulcer ; diagnosis

Diagnosis, Differential ; Humans ; Infant ; Male ; Neuroectodermal Tumors, Primitive ; pathology ; Orbital Neoplasms ; pathology

OBJECTIVE: To investigate the clinical manifestation and pathological features of primary ocular adnexal non-Hodgkin lymphoma. METHODS: Data of 18 patients with biopsy-proven ocular adnexal non-Hodgkin lymphoma at Xiangya hospital were reviewed.The disease site, clinical manifestation,imaging and pathological features of the tumor were summarized. RESULTS: All patients had typical presentation of an adnexal mass.Twelve(66.7%) patients had orbital involvement, 3(16.7%) had conjunctival, and 3(16.7%) had lymphoma involving the eyelids.Eight patients were misdiagnosed as "inflammatory pseudotumour" before the operation according to their clinical and imaging examination,another 8 patients were diagnosed as "ocular adnexal tumour with unknown nature" before the operation. According to the pathologic diagnosis, 16 patients (88.9%)had marginal zone lymphomas of mucosa-associated lymphoid tissue(MZL-MALT) and 2 (11.1%) had NK/T-cell lymphoma. CONCLUSION The typical presentation of ocular adnexal lymphoma is a painless mass.Orbital connective tissue is the most involved anatomical site. The diagnosis of ocular adnexal non-Hodgkin lymphoma is difficult which could easily be misdiagnosed as "inflammatory pseudotumour". MZL-MALT is the most common pathologic type.
Adolescent ; Adult ; Aged ; Diagnosis, Differential ; Eye Neoplasms ; diagnosis ; pathology ; Female ; Humans ; Lymphoma, Non-Hodgkin ; classification ; diagnosis ; pathology ; Male ; Middle Aged ; Orbital Neoplasms ; diagnosis ; pathology

PURPOSE: To present a case of peripheral T-cell lymphoma presenting as painful ophthalmoplegia. METHODS: A 61-year-old woman presented with a 2-week history of headache and eyeball pain. Examination showed mild exophthalmos, complete ophthalmoplegia, and ptosis of the left eye. Under the impression of nonspecific orbital inflammation, she was treated with oral prednisone with initial response. Two months later, she revisited the clinic with exacerbated symptoms. Anterior orbitotomy and incisional biopsy was performed for the inferior rectus muscle lesion. RESULTS: Histopathologic examination revealed an infiltrate of atypical lymphoid cells between degenerative muscle bundles. It was consistent with peripheral T-cell lymphoma. A metastatic workup was performed without any evidence of extraorbital tumor. The patient was recommended to be treated with chemotherapy, however, refused to take the treatment. The patient died of progression of the disease in a month. CONCLUSIONS: T-cell lymphoma in the orbit can present as painful ophthalmoplegia and take a rapid clinical course. The disease should be regarded as one of the differential diagnosis for painful ophthalmoplegia refractory to corticosteroid therapy.
Tomography, X-Ray Computed ; Pain/diagnosis/*etiology ; Orbital Neoplasms/*complications/diagnosis ; Ophthalmoplegia/diagnosis/*etiology ; Middle Aged ; Lymphoma, T-Cell/*complications/diagnosis ; Humans ; Female ; Fatal Outcome ; Diagnosis, Differential ; Biopsy

A 79-year-old male presented with left ocular pain. Evisceration and silicone ball implantation were performed after a diagnosis of phthisis. He returned six weeks later because of left facial erythematous swelling, tenderness, mild fever, chills and cough. His condition was diagnosed as orbital cellulitis. Despite two weeks of empirical antibiotic therapy, the symptoms worsened. A subsequent orbital computed tomography scan revealed enhanced soft tissue infiltrations in his left orbit and eyelid. Biopsy showed a diffusely infiltrating tumor of signet ring cell cytology. A systemic evaluation revealed multiple bone metastases. Based on this evidence, the patient was diagnosed with a very rare case of histiocytoid variant eccrine sweat gland carcinoma with multiple bone metastases.
Aged ; Carcinoma/*diagnosis/pathology ; *Eccrine Glands ; Histiocytes/*pathology ; Humans ; Male ; Orbital Neoplasms/*diagnosis/pathology ; Positron-Emission Tomography ; Sweat Gland Neoplasms/*diagnosis/pathology ; Tomography, X-Ray Computed

PURPOSE: It is important to differentiate malignant from benign lesions of intraocular masses in choosing therapeutic plan. Biopsy of intraocular tumor is not recommended due to the risk of visual damage. We evaluated the usefulness of F-18-FDG PET imaging in diagnosing intraocular neoplasms. MATERIALS AND METHODS: F-l8-FDG PET scan was performed in 13 patients (15 lesions) suspected to have malignant intraocular tumors. There were 3 benign lesions (retinal detachment, choroidal effusion and hemorrhage) and 10 patients with 12 malignant lesions (3 melanomas, 7 retinoblastomas and 2 metastatic cancers). Regional eye images (256*256 and 128*128 matrices) were obtained with or without attenuation correction. Whole body scan was also performed in eight patients (3 benign and 6 malignant lesions). RESULTS: All malignant lesions were visualized while all benign lesions were not visualized. The mean peak standardized uptake value (SUV) of malignant lesions was 2.64+/-0.57 g/ml. There was no correlations between peak SUV and tumor volume. Two large malignant lesions (>1000 mm3 ) showed hot uptake on whole body scan. But two medium-sized lesions (100-l000 mm3) looked faint and two small (<100 mm3) lesions were not visualized. The images reconstructed with 256*256 matrix showed lesions more clearly than those with 128X128 matrix. CONCLUSION: F-18-FDG PET scan is highly sensitivity in detecting malignant intraocular tumor. For the evaluation of small-sized intraocular lesions, whole body scan is not appropriate because of low sensitivity. A regional scan with sufficient acquisition time is recommended for that purpose. Image reconstruction in matrix size of 256*256 produced clearer images than the ones in 128X128, but it does not affect the diagnostic sensitivity.
Biopsy ; Choroid ; Diagnosis* ; Humans ; Image Processing, Computer-Assisted ; Melanoma ; Orbital Neoplasms ; Positron-Emission Tomography ; Retinoblastoma ; Tumor Burden ; Whole Body Imaging

PURPOSE: A Solitary fibrous tumor is a rare orbital neoplasm derived from mesenchymal cells. The neoplasm should be considered in differential diagnosis of any orbital tumor, and immunohistochemial analysis is important for correct diagnosis. The authors herein describe a case of a solitary fibrous tumor in addition to the findings of a literature review. Solitary fibrous tumors can develop from not only the lacrimal gland, but also orbital soft tissue. Until now, there has been no report of a solitary fibrous tumor arising from orbital soft tissue in Korea. CASE SUMMARY: A 50-year-old man visited our clinic due to a slow progressing mass on the lateral side of the left eye for 1 year. The patient did not suffer from any discomfort or discharge from the mass. Slit lamp and other ocular examinations were unremarkable. Orbital MRI revealed a solid extra-conal enhanced mass that measured 13x11 mm adhering to the lateral wall of the left orbit. Total surgical excision was Performed under local anesthesia and tumor cells showed a strong and diffuse positivity for CD34 by immunohistochemistry. The findings were consistent with the diagnosis of orbital solitary tumor. CONCLUSIONS: The orbital solitary tumor is rare, but it should be considered in the differential diagnosis of any orbital tumor.
Anesthesia, Local ; Diagnosis, Differential ; Eye ; Humans ; Immunohistochemistry ; Korea ; Lacrimal Apparatus ; Middle Aged ; Orbit ; Orbital Neoplasms ; Solitary Fibrous Tumors