João Pessoa Souza Filho

Histopathological review of sebaceous carcinoma of the eyelid

Background:  Sebaceous carcinoma of the eyelid can clinically mimic benign conditions, such as recurrent chalazion and inflammation and histopathologically squamous cell and basal cell carcinoma (BCC). This retrospective study was undertaken as an attempt to improve the characterization and consequently the diagnosis of these tumors.

Retinoblastoma in an adult: case report and literature review.

Retinoblastoma (RB) is a malignant neoplasm derived from photoreceptor precursor cells.1 In more than 90% of cases, the diagnosis is established before the patient reaches 5 years of age.2 RB is the most common intraocular malignant disease of childhood.3 It is rare in adults and for this reason is not usually considered in the differential diagnosis of a retinal or intraocular mass in an adult.4 We report a unilateral RB, with histopathological and immunohistochemical confirmation, in a 21-year-old woman. The base of the tumour had an area of welldifferentiated cells resembling retinocytoma (RC), and in our view the RB came from this benign neoplasm.

Basal cell carcinoma of the eyelid in children: a report of three cases

Basal cell carcinoma is the most common eyelid malignancy, accounting for approximately 90% of malignant eyelid tumours. Despite its prevalence in adults, it is extremely rare in children, and usually occurs in the setting of a known genetic defect or following radiotherapy treatment. We report three cases of de novo basal cell carcinoma in children. These children had no known genetic syndromes and had not undergone radiotherapy.

Acquired Brown's syndrome secondary to Ahmed valve implant for neovascular glaucoma.

Clinical findings included anterior uveitis, episcleritis, raised intraocular pressure, macular oedema, pigment dispersion, and retinal detachment. Angiostrongylus cantonensis, a lung fluke of rodents, was first described by Chen in 1935 from the bronchial tree of Rattus norvegicus and R.rattus rattus, caught in Canton, China. It is a delicate filiform worm, and has a length of 16-25 mm and a maximum diameter of 0.260.36 mm; the female of the species is larger. The rodent is the definite host. It is thought that humans are infected by eating inadequately cooked intermediate hosts (slugs, snails, crabs), or vegetables contaminated by larvae. The most likely routes of entry into the orbit are between the optic nerve and sheath, through the cribriform plate, and into the anterior chamber through the limbus. It is difficult to know where our patient came into contact with the infected intermediate molluscum host. Although he is resident in the United Kingdom, he had recently visited South Africa. Medline search, however, revealed no previous reports of ocular Angiostrongyliasis from United Kingdom or South Africa.

Relationship between histopathological features of chemotherapy treated retinoblastoma and P-glycoprotein expression.

Background: P‐glycoprotein (P‐gp) has been identifiedas a possible mediator of chemoresistance in retinoblastoma. Theaim of this study was to determine the expression of P‐gp in retinoblastomatreated with chemotherapy prior to enucleation.

Malignancy in the blind painful eye - report of two cases and literature review

BackgroundFew cases of malignant tumors arising in a blind painful eye have previously been described. We described two cases of a blind painful eye containing an unsuspected tumor, which were enucleated to relieve the pain.Case presentationsCase 1: A 57 year-old Caucasian man presented with recurrent orbital cellulitis and endophthalmitis in the left eye (OS). The OS was blind and painful and an enucleation was performed showing a uveal melanoma by histopathological exam. Case 2: A 54 year-old Caucasian man with previous history of a rhegmatogenous retinal detachment in his left eye presented a blind painful eye. Enucleation was performed revealing a well-differentiated B-cell lymphoma of uveal tract with extra ocular extension.ConclusionIn the management of a blind painful eye, it is extremely important to rule out an intraocular malignancy particularly in those patients who have not been followed by an ophthalmologist.

Fine needle aspiration biopsy to reestablish cell culture in an animal model of uveal melanoma.

PURPOSE To access the reliability of fine-needle aspiration biopsy in harvesting a sufficient amount of viable melanoma cells to establish a cell culture and maintain a melanoma cell line from an animal model of uveal melanoma. METHODS For this study, fifteen male New Zealand albino rabbits had their right eye surgically inoculated with uveal melanoma cell line 92.1. The animals were immunosupressed with cyclosporine A using a dose schedule previously published. The animals were followed for 12 weeks. Intraocular tumor growth was monitored weekly by indirect ophthalmoscopy. After the fourth week, one animal was sacrificed per week preceded by fine-needle aspiration biopsy using a sharp 25-gauge, 1-inch long needle. Two separate aspirates were made from different areas of the tumor. Each aspirate was flushed to a separate cell culture media and sent for cell culture. The cells were frozen after two weeks when there were at least 1 million cells, which is enough to maintain a cell line. Cells were defrosted for HMB-45 immuno-stains to confirm the melanoma origin. RESULTS Cell growth was observed from the samples harvested from 11 out of the 15 animals inoculated with uveal melanoma. All cell cultures, after defrost, immunoassayed positive for HMB-45. CONCLUSION Fine needle aspiration biopsy seems to be a reliable method to harvest cells from solid intraocular melanomas in an animal model, to establish cell culture and to maintain a melanoma cell line.

Choroidal neovascularization associated with sympathetic ophthalmia: case report

A 7-year-old boy with sympathetic ophthalmia secondary to penetrating ocular trauma developed choroidal neovascularization in the macular region of the sympathizing eye. Posterior segment biomicroscopy disclosed a single, round, small, slightly elevated yellow-white lesion temporal to the fovea, linked to the temporal edge of the optic disc by a fibrotic band. On fluorescein angiography the round lesion showed a gradual hyperfluorescence, with late staining and leakage, and was interpreted as a fibrovascular scar from previous choroidal neovascularization. Despite intense immunosuppressive therapy, the patients final visual acuity was 20/400. Although rarely associated with sympathetic ophthalmia, choroidal neovascularization and its cicatricial stages can occur and compromise the visual prognosis of an already debilitated eye. The best course of treatment for choroidal neovascularization in these types of cases has not yet been determined.

Cytokeratin expression in corneal dystrophies

PURPOSE To identify an immunohistochemical pattern of epithelial markers in granular, lattice and Avellino corneal dystrophies. METHODS Twenty-two corneal buttons, diagnosed as lattice (17), Avellino (4) and granular (1) underwent immunohistochemical studies of cytokeratins (CKs) on paraffin-embedded sections (group I). Monoclonal antibodies for pan-CK (AE1/AE3) and CKs 3/12, 5/6, 8, 18 and 19 were used. Twenty-two normal corneas were used as the control (group II). RESULTS Six lattice and 2 Avellino cases of group I stained positively with anti-CK 3/12 in corneal epithelium and areas of corneal stroma deposits. One of these cases of lattice was positive for anti-pan-CK (AE1/AE3) also in the epithelium and areas of corneal stroma deposits with a similar pattern. None of the controls (group II) revealed any staining in corneal stroma. All disease and control cases (groups I and II) revealed positive staining in corneal epithelium. CONCLUSION AE1/AE3 and CK 3/12 anti-CK positive markers in the stromal deposits of lattice and Avellino dystrophies may suggest an epithelial genesis of the disease.