Primary vitreoretinal lymphoma: prevalence, impact, and management challenges

Ramesh Venkatesh,1 Bharathi Bavaharan,1 Padmamalini Mahendradas,2 Naresh Kumar Yadav1 1Department of Retina and Vitreous, Narayana Nethralaya, Bengaluru – 560010, India; 2Department of Uvea and Intraocular Inflammation, Narayana Nethralaya, Bengaluru – 560010, India Abstract: Primary vitreoretinal lymphoma (PVRL) is a rare and potentially fatal intraocular malignancy. More than half of PVRL cases eventually involve the central nervous system (CNS). PVRL frequently masquerades as chronic uveitis. Advanced imaging tests, such as optical coherence tomography and fundus autofluorescence, have been applied in the diagnosis of PVRL. Histology and immunohistochemistry, in combination with molecular tests and IL-10 analysis, have been demonstrated as reliable in diagnosing PVRL. Mortality is high in patients with PVRL associated with CNS involvement, and relapses are common. The use of systemic chemotherapy in addition to the local therapies has proved to extend the mean survival time of these patients. Local therapies, including intravitreal injections of methotrexate and/or rituximab and low-dose radiotherapy to the eye, have been shown to be extremely effective in controlling intraocular lymphoma. Keywords: CNS lymphoma, malignancy, ocular tumor, treatment, investigations, prognosi

CT guided radiofrequency ablation for an osteoid osteoma in the pediatric proximal humerus

Background: Osteoid osteoma is a benign tumor commonly seen in the lower extremity. It presents between the ages of 10 and 30 years with male predominance. The most common symptom is bone pain, worsening at night and relieved by aspirin or nonsteroidal anti-inflammatory drugs. Osteoid osteoma in the pediatric proximal humerus is rare. Case description: We report a 14-year-old girl with an osteoid osteoma in the proximal humerus successfully treated by CT-guided RF ablation. Literature review: There is a considerable delay in the diagnosis because of common pathological conditions around the shoulder mimic osteoid osteoma. Computer Tomography is the best imaging modality to visualize the nidus and radiolucent lesion and assist in the treatment. Clinical relevance: CT-guided percutaneous radiofrequency ablation of proximal humerus osteoid osteoma in children is safe, effective, and a reliable method alternative to surgery with a low complication and recurrence rate