• Title/Summary/Keyword: Orbital disease

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A Case of Langerhans Cell Histiocytosis Mimicking Periorbital Cellulitis (안와 주위 봉와직염을 동반한 랑게르한스 세포 조직구증 1례)

  • Yoo, Ha Yeon;Kim, Ki Hwan;Choi, Jun Jeong;Kim, Dong Soo
    • Pediatric Infection and Vaccine
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    • v.16 no.2
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    • pp.220-223
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    • 2009
  • Langerhans cell histiocytosis is a rare disease in children. However, Langerhans cell histiocytosis encompasses a wide spectrum of clinical presentations and mimics other conditions. A 1-year-old boy presented with signs of periorbital cellulitis that initially responded to antibiotics, but remained as a same-sized mass with serial orbital computed tomography. The lesion was partially excised. Histopathology and immunohistochemical staining confirmed the diagnosis of Langerhans cell histiocytosis. This case demonstrates that in patients with periorbital cellulitis which has relapsed or responded inadequately to antibiotics, further investigation should initiated to rule out other inflammatory causes.

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A Case of Unusual Tolosa-Hunt Syndrome (비전형 Tolosa-Hunt Syndrome 1예)

  • Lee, Sun-Sook;Kim, Kyung-Sook;Han, Young-Jin;Choe, Huhn
    • The Korean Journal of Pain
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    • v.2 no.2
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    • pp.198-202
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    • 1989
  • The Tolosa-Hunt syndrome is one of the rare disease with facial, especially peri-orbital pain, and ophthalomoplegia associated mostly with granulomatous lesions in cavernous sinus or superior orbital fissure. In addition to ophthalmoplegia by multiple cranial nerve involvement, the sympathetic nervous system may also be involved leading to Horner's syndrome. A typical Tolosa-Hunt syndrome has a neuro-radiologic finding of an increased density in the involved region, and a laboratory finding of an elevated ESR, as well as a dramatic response to systemic corticosteroid therapy. An unusual case of the Tolosa-Hunt syndrome with normal radiologic and laboratory findings, unresponsive to systemic corticosteroid, and some response of pain relief to a stellate ganglion block, is presented.

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Exophthalmometric values using White-light Scanning Interferometer (백색광 간섭계를 이용한 안구돌출값 측정)

  • Chang, Jung-Soo;Kim, Young-kil
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2017.05a
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    • pp.175-178
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    • 2017
  • The relative position of the eyeballs in the orbit can be a criterion for estimating multiple pathological conditions. Especially, it is useful to diagnose orbital fracture, thyroid eye disease, orbital tumor, and to evaluate the result of drug and surgical treatment. The Hertel and the Naugle exophthalmometer, which are typical measuring instruments used mainly to measure the protrusion of the eye, are inevitably error by the measurer. In this paper, we propose a method to increase the accuracy and repeatability of the measurement of eyeball exophthalmometric values by using a white light interferometer.

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A Case of Spontaneous Resolution of Idiopathic Mediastinal Fibrosis (자연소실의 경과를 보인 특발성 종격동 섬유화증 1예)

  • Wang, Joon-Ho;Song, Kwang-Seon;Kim, Hyun-Jun;Song, Ki-Ho;In, Haing-Hwan;Choi, Su-Bong;Joo, Mi-Yeun;Sung, Ki-Joon;Shin, Kye-Chul
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.935-941
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    • 1997
  • Mediastinal fibrosis is pathologically characterized by chronic inflammation and fibrosis of mediastinal soft tissue. Mediastinal fibrosis is local expression of a family of systemic fibrosing syndroms. This can result in compression of adjacent mediastinal structures. Idiopathic fibrosing syndromes include retroperitoneal fibrosis, sclerosing cholangitis of the orbit and fibrosis of the thyroid gland(Riedel's struma). The cause of these disorders is obscure, in some instance there is an underlying malignancy, infection, history of drug ingestion, or trauma with retroperitoneal bleeding. Treatment of mediastinal fibrosis depends on structures involved by the fibrotic process. The disease is self limited in most case or improved by steroids uses. We experienced a case of idopathic sclerosing mediastinitis with orbital fibrous dysplasia of unknowm cause, which was confirmed by open lung biopsy, so reported it with a review of literature.

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Exophthalmometric values using White-light Scanning Interferometer (백색광 간섭계를 이용한 안구 돌출 값 측정)

  • Chang, Jung-soo;Kim, Young-kil
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.21 no.12
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    • pp.2341-2346
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    • 2017
  • The relative position of the eyeballs in the orbit can be a criterion for estimating multiple pathological conditions. Especially, it is useful to diagnose orbital fracture, thyroid eye disease, orbital tumor, and to evaluate the result of drug and surgical treatment. The Hertel and Naugle exophthalmometer, which are the most commonly used measuring instruments for measuring the prominence of the eye, are different from each other. Even if the same examiner repeatedly measures, it is inevitable. Also, even if the same exophthalmometer is different from the manufacturing company, the design of the fixed part of the orbit is different, and a measurement error is caused by the inspectors. In this paper, we propose a method of automatic measurement that can increase the accuracy and repeatability of measurement of exophthalmos using white light scanning interferometer, which is a 3D image measurement technique.

IgG4-related Ophthalmic Disease Associated with Adult Xanthogranulomatous Disease (황색육아종과 동반된 면역글로불린G4관련안질환 1예)

  • Lee, Seunghyun;Chung, Sokjoong;Heo, Jinhyung;Lew, Helen
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.11
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    • pp.1071-1076
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    • 2018
  • Purpose: To report a case of immunoglobulin G4 (IgG4)-related ophthalmic disease associated with adult xanthogranulomatous disease. Case summary: A 38-year-old male with a history of cholecystectomy visited our clinic for bilateral periorbital swelling. Histopathology of the orbital biopsy showed diffuse infiltration of foamy histiocytes with Touton giant cells and lymphoid follicles, with a diagnosis of adult-onset xanthogranuloma. After excisional biopsy, he was treated with azathioprine and prednisolone. Four years after treatment, he again visited the clinic due to bilateral, yellowish eyelid masses. Serological examinations were all nonspecific findings, except for elevation of IgG and IgG4 levels. Magnetic resonance imaging showed bilateral symmetric soft tissue enlargement with slightly heterogeneous T1/T2 isosignal intensity, with contrast enhancement at the superolateral aspect of extraconal spaces. Excisional biopsy and blepharoplasty were performed. Immunohistochemical sections showed that the IgG4+/IgG plasma cell ratio was 10-20% and the IgG4 plasma cell count was 22/high power field (HPF). His past sections of 2013 from the pathology department were again stained and showed that the IgG4+/IgG plasma cell ratio was 40-50% and the IgG4 plasma cell count was 59/HPF. Thus, he was definitely diagnosed with IgG4-related ophthalmic disease. Conclusions: If there is recurrent eyelid swelling, IgG4-related ophthalmic disease should be considered as a differential diagnosis. And the patient with adult xanthogranulomatous disease can be diagnosed with IgG4-related ophthalmic disease.

Extensive and aggressive growth of adenoid cystic carcinoma in the lacrimal gland

  • Park, Jonghyun;Kim, Han Koo;Kim, Woo Seob;Bae, Tae Hui
    • Archives of Craniofacial Surgery
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    • v.21 no.2
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    • pp.114-118
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    • 2020
  • Adenoid cystic carcinoma (ACC) in the lacrimal gland is a very rare disease with poor overall prognosis. Its primary treatment is surgical excision, including orbital exenteration and radical orbitectomy, which is combined with radiotherapy and chemotherapy. Age, histopathologic type, bone invasion, and tumor extent are known factors that affect the prognosis of ACC. Furthermore, perineural invasion is highly associated with local tumor recurrence and tumor base invasion. Here, we report a rare case of ACC in the lacrimal gland with superior sagittal sinus invasion that repeatedly recurred after the surgical excision.

A Clinical Experience of Neurofibromatosis Involving Periorbital Region (안와부위에 발생한 신경섬유종증의 임상적 치험례)

  • Park Dae-Hwan;Kim Tae-Mo;Han Dong-Gil;Ahn Ki-Young
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.1
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    • pp.86-89
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    • 1997
  • Neurofibromatosis, now termed neurofibromatosis type I, is known as a congenital and familial disease presenting abnormalities of the skin, nervous system, bones, and soft tissue. We experienced a case of extremely large neurofibromatosis which developed on the orbital and temporal region of a 24-year-old man. The tumor was widely excised including normal skin margin, outer table of cranium, a part of zygoma and maxilla. Bony defect was reconstructed by rib bone graft and secondary cosmetic correction of blepharoptosis was performed using supratarsal fixation in postoperative 6 months.

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Invasive sphenoid sinus aspergillosis with normal findings on initial diagnostic tests that mimics Tolosa-Hunt syndrome-a diagnostic dilemma: a case report

  • Yu Hun Jeong;Jongsuk Choi;Byung-Jo Kim;Hung Youl Seok
    • Journal of Yeungnam Medical Science
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    • v.40 no.2
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    • pp.198-201
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    • 2023
  • Invasive sphenoid sinus aspergillosis can mimic Tolosa-Hunt syndrome (THS), leading to frequent misdiagnoses and potentially fatal consequences. We report a case of invasive sphenoid sinus aspergillosis initially misdiagnosed as THS. A 79-year-old man presented with right periorbital pain, ophthalmoplegia, and loss of vision. Initial evaluations including magnetic resonance imaging (MRI), were normal. He was first diagnosed with THS based on clinical features. The disease progressed despite high-dose intravenous steroid treatment, and an enhancing mass-like lesion was found in the right orbital apex, cavernous sinus, and sphenoid sinus on follow-up MRI. Aspergillosis was eventually confirmed by sphenoid sinus biopsy. The patient developed cerebral infarction and finally died despite being treated with amphotericin B. Given that invasive sphenoid sinus aspergillosis may initially resemble THS, high suspicion and rapid histological examination are important for diagnosis.

Clinical presentation and treatment outcomes of primary ocular adnexal MALT lymphoma in Thailand

  • Seresirikachorn, Kasem;Norasetthada, Lalita;Ausayakhun, Sakarin;Apivatthakakul, Atitaya;Tangchittam, Sirima;Pruksakorn, Vannakorn;Wudhikarn, Kitsada;Wiwatwongwana, Damrong
    • BLOOD RESEARCH
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    • v.53 no.4
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    • pp.307-313
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    • 2018
  • Background Primary ocular adnexal extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (POML) is the most common subtype of lymphoma involving the eyes in Thailand. We sought to assess the characteristics and treatment outcomes of patients with POML in Thailand. Methods We retrospectively reviewed patient data and included patients diagnosed with POML between January 2004 and December 2016 at Chiang Mai University Hospital and King Chulalongkorn Memorial Hospital, Thailand. We collected and analyzed patients' clinical characteristics and treatment outcomes. Results Among 146 patients with lymphoma involving the eyes, 121 (82%) were diagnosed with POML. Sixty-four (52.9%) were women with median age 58 (range, 22-86) years. The most common presenting symptom was orbital mass (71.1%). Common sites of origin were the orbit (46.3%) and lacrimal gland (34.7%). At presentation, 22.3% of patients had bilateral eye involvement. About half of patients had stage I disease (N=59, 56.2%) and 20% had stage IV. Most patients (73.3%) had a low-risk International Prognostic Index. Radiotherapy was the main treatment for patients with limited-stage disease (66.7% in stage I and 56.5% in stage II). The overall response rate was 100% with complete response rates 80%, 77.3%, and 64.7% for stages I, II, and IV, respectively. Five-year progression-free survival (PFS) and overall survival were 66.1% and 94.0%, respectively. For patients with limited-stage disease, radiotherapy significantly improved PFS compared with treatment not involving radiotherapy (5-year PFS 89.9% vs. 37.3%, P=0.01). Conclusion We revealed that POML has good response to treatment, especially radiotherapy, with excellent long-term outcome.