Medial Canthus Of Left Eye Research Articles

Pleomorphic adenoma of lateral wall of nose: A case report

Pleomorphic adenoma is a benign mixed tumour most frequently occurring in major salivary glands mainly parotid gland followed by minor salivary glands and lacrimal glands. It occurs rarely in skin and subcutaneous tissue where it had been previously termed as chondroid syringoma. Here we present a case of 22 years female presenting with a small subcutaneous swelling on left lateral wall of nose near medial canthus of left eye slowly progressing in size since 2 years and its histocytocorrelation. Complete excision and histopathology of such lesions is necessary as there may be recurrences and malignant transformation.

A RARE CASE REPORT OF GLOMUS TUMOUR OVER MARGIN OF LOWER LID OF LEFT EYE

Introduction: Glomus tumours are rare, benign tumours of vascular origin, arising from the glomus body. Glomus tumours are neoplasms of mesenchyme derived from glomus bodies. Glomus tumours present as a purple or pink vascular lesion that can be confused with a vascular neoplasm such as hemangioma. In this case we are reporting a rare presentation of glomus tumour over lower lid. A 10 year old female child presented with lesion over left lower Case Report: lid since 3 months which was painless and progressive. On examination a 0.3x0.3 cm subcutaneous pink non encapsulated mass is seen over medial canthus of left eye. Mass was excised and subjected to histopathological examination which conrmed the diagnosis of glomus cell tumour(glomangioma). Postoperative period was uneventful with no recurrence for last 6months. Conclusion: All excised eyelid lesions should undergo detailed Histopathological evaluation and glomus tumour should be considered as one of the differential diagnosis in patients presenting with eyelid mass.

Primary amyloidosis of conjunctiva.

A 64-year old male presented in ophthalmology OPD for follow up for refractive errors. He had been wearing bifocal lenses from last 1 year. On local examination, medial canthus of left eye showed a pale yellowish plaque. The rest of the ocular examination and contralateral eye were normal. Slit lamp examination showed a confluent fusiform papule (Figure 1A,B). Computed tomography (CT) scan of the orbit showed no abnormality. Surgical excision was done and tissue sent for histopathological examination showed deposition of a pink homogeneous material in the fibrocollagenous tissue beneath the conjunctival epithelium (Figure 1,C). Congo red stain followed by polarizing microscopy confirmed the pink material to be amyloid with apple green birefringence (Figure 1D,E). Immunohistochemistry (IHC) showed lambda light chain restriction. A diagnosis of conjunctival amyloidosis was made. The patient was then evaluated to rule out systemic amyloidosis or plasma cell dyscrasia. The patient was asymptomatic with no history of trauma, systemic illness, and family history was non-contributory. General and systemic examinations were unremarkable. Complete hemogram, urea, creatinine, liver function test, erythrocyte sedimentation rate, blood glucose, and serum calcium were within normal limits. No abnormality was detected on skeletal survey, electrocardiography, 2D-echocardiography, and ultrasonography of abdomen. Serum protein electrophoresis, serum immunofixation electrophoresis, serum free light chain assay, 24-h urine protein, and urine protein electrophoresis were non-contributory. Bone marrow showed mildly increased plasma cells without light chain restriction on immunohistochemistry. Finally, a diagnosis of primary conjunctival amyloidosis was made and the patient was asked to follow up. Conjunctival amyloidosis occurs secondary to local inflammation and primary form of the disease is very rare. In a previous series published on ocular amyloidosis, only two of 26 ocular cases collected over 30 years had conjunctival involvement. Identification of the disease is a daunting task owing to protean manifestations. Differentiating it from conjunctival inflammation and malignancies is essential. Evaluation for systemic causes is important as the treatment modalities are completely different. While localized form might just need observation or surgical debulking, systemic AL amyloidosis or myeloma would necessitate administration of specific chemotherapy. A long-term follow up is also necessary as recurrence is a known phenomenon and evolution into systemic disease is also a possibility. Concepts design, definition of intellectual content, Literature search, data analysis, manuscript preparation, and manuscript editing: Karuna Jha. Concepts design, definition of intellectual content, manuscript editing: Maitreyee Bhattacharyya. Dr Bhaskar Mitra, Consultant Pathologist, Tribedi and Roy Lab, Kolkata. The authors declare they have no conflicts of interest. The authors received no specific funding for this work. No research on human was performed on this study. Informed consent was taken from the patient. The data that support the findings of this study are available from the corresponding author upon reasonable request.

Foreign Body Nose: An Unusual Presentation

Introduction This is a very interesting case of retained homicidal foreign body in the nose in contrast to most of the foreign bodies which are accidental. Case Report A 27 year old male presented to ENT emergency with alleged history of assault over face with sharp object following which patient developed nasal bleed. On examination vertical laceration of approximately 8 cm in length was present along left naso-orbital groove extending superiorly from medial canthus of left eye and inferiorly to nasal alar cartilage. On anterior rhinoscopy a metallic foreign body was seen in both nasal cavities, which appeared to be crossing from left to right side piercing the nasal septum. Foreign body was removed via open approach. Discussion Penetrating maxillofacial injury with foreign body impaction are less common. High index of suspicion is required in diagnosing these cases. Radiological intervention should be done to get idea of exact location and extent of foreign body. Lateral rhinotomy is a useful approach in removing these foreign bodies.

Rare Case of Malignant Melanoma of Lacrimal Sac

Presentation A 60 year old female presented to our clinic in July 2015 with complaints of left eye epiphora, and painless gradually increasing mass in the medial canthal area for 4 months. Probing revealed hard stop. At the time the mass was above the MCT and appeared separate from lacrimal sac. She was advised biopsy, but was lost to follow-up, only to present 6months later with a massive increase in the size of mass. There was no history of bloody discharge. On Examination, both eyes had senile cataract with BCVA of 6/24 in Right eye and absent light perception in left eye. A single, irregular, diffuse, firm mass was present in the medial canthal area of left eye, measuring approximately 2.5cmX2.5cm in size, with 3mm horizontal dystopia and blackish skin pigmentation. It involved the medial part of both upper and lower lid, lacrimal sac and canaliculi. It was non tender, immobile, with no surface ulcerations or pulsations. Excessive watering was present in the left eye, syringing could not be done since puncta were not visualized. There were no other swellings, no lymphadenopathy, and no history of significant weight loss. Hematological investigations were normal. Neuroimaging revealed a well-defined heterogenously enhancing solid lesion in the region of medial canthus of Left eye, about 2.3X2.8X1.7cm, involving the extraconal space, causing scalloping and widening of Left lacrimal fossa and NLD, and mild lateral displacement of the globe. Incisional biopsy showed tumor tissue composed of clusters of malignant cells-pleomorphic with high nuclear-cytoplasmic ratio, vesicular nuclei and prominent eosinophillic macronuclei. Foci of melanin pigment deposition were seen, leading to a diagnosis of malignant melanoma of the lacrimal sac. Metastatic work-up revealed lytic lesions in left frontal and right parietal skull bones and fibronodular opacities in upper and middle lobes of right lung, alongwith mediastinal lymphadenopathy. Hence the final staging was T4aN0M1c. No surgical treatment was planned and instead patient was referred for palliative systemic chemotherapy and radiotherapy. Discussion Malignant melanoma is a malignancy of the pigmentproducing melanocytes. It usually affects the skin and rarely