Prise en charge des tumeurs palpébrales : considérations générales.

Despite the fact that the majority of eyelid tumors are benign, proper management in daily practice requires detection of the malignant ones. Several clinical criteria are usually proposed to support or reject a hypothesis of malignancy; however, most are of limited reliability. In any case of doubt, outpatient biopsy is recommended, so as to establish the correct diagnosis and formulate the most appropriate treatment plan. In all facial malignancies, the first (and absolutely mandatory) consideration is control of the cancer. Then, restoration of eyelid function can be addressed, in the following order: protection of the globe by complete dynamic eyelid closure and opening, visual function (and prevention of possible deprivation amblyopia) by insuring a clear visual axis, correction of the tear film, efficient lachrymal drainage, and only then the role of the eyelids in facial expression and esthetics. For most malignant eyelid tumors, the best assurance of complete excision is obtained by extemporaneous examination of the resection margins by frozen section (by Mohs' micrographic surgery techniques, or a variation thereof). Currently, advancement and transposition flaps, possibly in combination with tarso-conjunctival or skin grafts, are the most utilised techniques. Despite the lack of histological verification, new treatment modalities, including topical chemotherapy, photodynamic therapy and cryotherapy, may provide interesting treatment options, particularly in collaboration with the dermatologist.English AbstractJournal ArticleReviewSCOPUS: ar.jinfo:eu-repo/semantics/publishe

Experimental approach to surgical treatment of lacrimal insufficiency by microvascular submandibular salivary gland autotransplantation.

When compared to the parotid duct transposition, the microvascular submandibular salivary gland autotransplantation presents the advantage of providing a more viscous tear substitute, and a basal flow rate unaffected by meals. If future attempts to re-innervate the graft are successful, this procedure could be promising in restoring an acceptable lacrimal function in severe xerophthalmia.Journal ArticleSCOPUS: ar.jinfo:eu-repo/semantics/publishe

Tumeurs palpébrales: aspects cliniques et diagnostiques.

The vast majority of palpebral tumors are benign and, when complete, straightforward excision is curative. In some cases, laser ablation can be appropriate. These tumors originate from the pilosebaceous adnexa of the skin and are mainly composed of cysts. For carcinomas, the extent of the tumoral expansion must be assessed on pathological examination of a specimen. In case of recurrence, the tumor may extend beyond the clinically visible borders. This is particularly true in the sclerodermiform type of basal cell carcinoma, which invades tissues deeply, in spindle cell carcinoma, which spreads within the thickness of the epidermis or the conjunctival epithelium, and in sebaceous gland carcinoma, which can present in a masquerade fashion.English AbstractJournal ArticleSCOPUS: ar.jinfo:eu-repo/semantics/publishe

La pathologie des annexes oculaires d'origine toxique.

Ocular adnexa represent a complex system of delicate organs and functions which are the target of varied side effects. Most involve more than one component at a time, however landmark signs and symptoms can be outlined. Dry eye leads the list. The aqueous production of the tear film can be decreased by certain psychotherapeutic agents (especially the older ones), while the phospholipidic component, produced by the Meibomian glands, can be markedly affected by retinoids. On the other hand, cytostatic drugs like Docetaxel (and 5-FU at a lesser degree) frequently induce canalicular stenosis, resulting in epiphora. Amongst a long list of substances, diphosphonates used in the treatment of osteoporosis and phosphodiesterase-5 inhibitors used in erection deficiencies induce conjunctival irritation, either directly or by contiguity. Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis represent the most severe toxic insult to the mucosae. A recent chemotherapeutic agent, Imatinib, induces fluctuant palpebral edema in a majority of patients. Despite being applied topically, prostaglandin analogs exert a profound effect onto the cellular physiology of the eyelash and the ocular and palpebral melanocyte. Indirectly, immunosuppressive agents used in graft rejection control have been associated with the emergence of secondary neoplasia, mainly lymphoma, of which the orbit is a rare but possible location. Chronic administration of steroid drugs leads to hypertrophy of the orbital fat and proptosis.English AbstractJournal ArticleReviewSCOPUS: re.jinfo:eu-repo/semantics/publishe

Tumeurs palpébrales: aspects cliniques, diagnostiques et thérapeutiques

0info:eu-repo/semantics/publishe

Cytogenetic analysis of rare orbital tumors: further evidence for diagnostic implication.

INTRODUCTION. The pathologic diagnosis, and hence the management, of rare tumors of the orbit can represent a challenge. An increasing number of tumors have been shown to display specific chromosomal abnormalities detectable by cytogenetic analysis. MATERIALS AND METHODS. Two examples of rare primary orbital tumors are presented in which the correct pathologic diagnosis was either established or confirmed by cytogenetic analysis. Small pieces of the tumor were obtained at the time of biopsy and placed immediately, in a sterile fashion, in fresh culture medium. The cells were Giemsa stained and processed for chromosome analysis. RESULTS. In the first case, a 12-year-old boy was diagnosed with a sino-orbital mass after sustaining minor trauma. On biopsy, the pathologic examination was at first consistent with a Burkitt-like lymphoma, until cytogenetic analysis showed a t(8;21)(q22;q22) translocation, specific for granulocytic sarcoma, which corresponds to the localized solid form of acute myeloblastic leukemia. Consequently, proper chemotherapy was re-oriented and remission was achieved. In the second case, a 2-year-old boy presented with a well-vascularized orbital tumor. The histopathologic diagnosis of alveolar soft-part sarcoma of the orbit was confirmed by the finding of a specific t(X;17)(p11;q25) translocation. After two unsuccessful courses of chemotherapy, wide excision surgery with primary reconstruction brought remission. CONCLUSIONS. Cytogenetic analysis should be considered in the diagnosis of any orbital tumor which is suspected of malignancy.JOURNAL ARTICLESCOPUS: cp.jinfo:eu-repo/semantics/publishe

Esotropie mixte et mydriase par atteinte du ganglion ciliaire après traumatisme oculaire

info:eu-repo/semantics/nonPublishe

Ophthalmia nodosa caused by tarantula hairs.

Case ReportsJournal Articleinfo:eu-repo/semantics/publishe

Métastase orbitaire entraînant une diplopie et une enophtalmie

info:eu-repo/semantics/nonPublishe