Retrobulbar Tumor Research Articles

A rare case of Radius Maumenee syndrome with unilateral open angle glaucoma

Elevated episcleral venous pressure (EEVP) is a rare but important cause of raised intraocular pressure. The resultant glaucoma is often severe and refractory to routine anti glaucoma treatment. Usually it occurs due to arteriovenous fistulas or venous congestion. This entity is important to detect as it may be associated with serious pathologies like retrobulbar tumor, cavernous sinus thrombosis, mediastinal tumor to name a few. EEVP is considered idiopathic after ruling out such disorders. Here, we have described idiopathic EEVP also known as Radius-Maumenee syndrome along with a detailed diagnostic and therapeutic approach of management.

Application value of the contrast-enhanced ultrasound in the diagnosis of orbital retrobulbar tumors

Application value of the contrast-enhanced ultrasound in the diagnosis of orbital retrobulbar tumors

Retinoblastoma Morphology after Local Chemotherapy

Purpose. Determine the nature of tumor regression and possible complications associated with the retinotoxic effect of melphalan and carboplatin with local chemotherapy.Methods. A histological analysis of 19 enucleated eyes from 19 patients with retinoblastoma was performed after combined organ-preserving treatment, including systemic chemotherapy and local chemotherapy in various doses. The enucleated eyes were fixed in 10 % formalin and processed routinely for histological examination.Results. Significant changes in the tumor tissue such as tumor regression associated with the destruction of the tumor tissue and its replacement with fibrous tissue, glia proliferation, and the formation of petrificates were revealed. Complete regression of the tumor was detected in 3 out of 19 eyes, partial in 13 eyes. There were no signs of regression in 3 eyes. Tumor invasion into the choroid was found in 5 cases, into the anterior sector — in 3 cases, into the optic nerve — in 3 cases. The retrobulbar tumor was presented in 1 case. Retinotoxic complications revealed. Hemorrhagic changes associated with focal necrosis of the central retinal vessels (n = 4), destructive changes in retinal pigment epithelium (RPE; n = 10) associated with the accumulation of melphalan in RPE leading to atrophic processes in the retina. Complications in the form of secondary glaucoma, severe fibrosis and retinal detachment, despite the complete resorption of the tumor, led not only to loss of vision, but also hindered visualization of the fundus and substantiated the need for enucleation in 3 cases. In other cases, enucleation was performed due to continued tumor growth (n = 16) or progression during treatment (n = 3).Conclusions. Retinoblastoma can be controlled with local chemotherapy. However, clinical and morphological examinations of enucleated eyes revealed and confirmed, along with tumor resorption, intraocular complications as a result of the toxic effect of the drugs and the presence of active tumor tissue to varying degrees of therapeutic pathomorphism, which can be explained by the resistance of RB to these drugs. Thus, a further search is needed for drugs that destroy the tumor and minimize the retinotoxic effect.

Post-operative optical coherence tomography angiography features of chorioretinal folds resulting from pleomorphic adenoma of the lacrimal gland (PALG) of orbit- a case report

BackgroundChorioretinal fold (CFs) is a rare condition resulting from undulations in the choriocapillaris, Bruch's membrane, retinal pigment epithelium and occasionally neurosensory retina. It can be idiopathic or due to different etiologies. The use of spectral-domain optical coherence tomography (SD-OCT) has increased the diagnosis of CFs and helped in differentiation from other etiologies. Recently, optical coherence tomography angiography (OCT-A) emerged as a non-invasive imaging technique allowing visualization of the individual layers of microvasculature of the retina and the choroid by comparing consecutive B-scans. We described a rare case of pleomorphic adenoma of the lacrimal gland (PALG) causing hyperopic shift and CFs with the new OCT-A technology, getting deeper insight into vascular changes of this disease.Case presentationA 40-year-old Asian man experienced progressive blurred vision in his right eye over 6 months. The patient’s initial axial lengths were 25.55 mm in the right eye and 28.13 mm in the left eye. Fundus examination in the right eye revealed oblique CFs as well as the SD-OCT displayed. Magnetic resonance imaging showed intraconal mass extended from superior temporal side of the right orbit. The patient then received tumor removal surgery through lateral orbitotomy and histopathology confirmed a pleomorphic adenoma of the orbit.The patient had regular follow-up for 1 year. His best corrected visual acuity markedly improved from 20/50 to 20/20 with nearly stationary AXL. We performed OCT-A at one year after the surgery, which showed early visualization of deep choroidal vessels. The scleral remodeling due to mass effect of retrobulbar tumor also caused displacement of the deep large choroidal vessels over the superior macular area even after tumor removal.ConclusionsWe reported a rare case of PALG with hyperopic shift and CFs as initial presentation. Surgical removal of the tumor partially resolved the CFs and contributes to impressive visual acuity recovery. The use of OCT-A provided a deeper insight to vascular architecture changes resulting from scleral remodeling after long-term tumor compression.

Rehabilitation after surgical treatment of retrobulbar tumors.

The authors propose a set of rehabilitation exercises concerning the muscles which are responsible for movement of the eyeball. After surgical treatments of retrobulbar tumors, the function of the eyeball muscles is often inadequate. Some compensation should be created at the level of the central nervous system, which means trigging adaptation, substitution and habituation. The exercises should be started just after the patient is awakened: first in the horizontal position, then sitting position and finally standing position. The highest number of exercises should be done in the direction of extreme diplopia.

Infraorbital approach for retrobulbar orbital neurofibroma: a case report

<p class="abstract">Retrobulbar orbital tumours are rare and treatment is challenging. These tumors include cavernous hemangioma, neurofibroma, A-V malformations, glioma etc. A variety of approaches have been used in resection of these tumours. The various approaches in literature include endoscopic transethmoidal and sphenoidal, lateral orbitotomy, transmaxillary infraorbital, and cranial and sub cranial approaches. Such tumours located inferior to the optic nerve can be reached through infraorbital approach avoiding traction on optic nerve or pressure on globe. We are reporting a retrobulbar orbital neurofibroma in a middle aged lady who presented with unilateral loss of vision, episodic giddiness, severe left sided headache, left orbital pain and epiphora on exposure to sunlight. MRI showed well defined 1.8×1.8×1.7 cm enhancing lobulated solid left intraorbital mass extending along the substance of inferior aspect of left optic nerve with mass effect. With transmaxillary infraorbital endoscope assisted approach, the retrobulbar tumor was exposed and enucleated. Floor of orbit was reconstructed with tensor fascia lata and nasal septal cartilage graft. The patient had uneventful recovery and immediate post operative visual acuity was perception of light and likely to improve further. Histopathology revealed neurofibroma. This case report highlights the advantages of infraorbital approach as it is a simple approach along the suture lines through the orbital floor with the help of endoscopic guidance. It has the advantages of avoiding traction on optic nerve or optic chiasma, no retraction of brain, no communication with cranial cavity, no pressure on globe and easy reconstruction of orbital floor.</p>

Isolated Retrobulbar Hydatid Cyst: A Case Report

Background: Hydatid cyst is caused by Echinococcus granulosus and human is the accidental host. The most common sites of involvement are the liver and lungs, and involvement of other organs is less common. Ocular involvement of hydatid cyst is one of the most uncommon manifestations of hydatid cyst. Cases Report : The case was a 40-year-old woman with a retrobulbar cystic lesion who was examined for the left eye pain and then proptosis. With the initial diagnosis of retrobulbar tumor, the patient underwent surgery and the removed mass was sent to the pathology laboratory. Since the result indicated the existence of a hydatid cyst, the patient was referred to the infectious service and was treated with albendazole. C onclusion: Although the ocular involvement of hydatid cyst is uncommon, it should be considered as a differential diagnosis in patients with proptosis in the endemic areas.

Orbital multilobular osteochondrosarcoma in a dog

Retrobulbar tumors may arise from any orbital tissue. Some are primary and others may extend from adjacent structures or derived from metastases. Multilobular osteochondrosarcomas are regarded as slowly growing and potentially malignant neoplasms in dogs. This tumor is of rare occurrence on retrobulbar region. This paper aims to report a rare case of female dog, Shih Tzu, spayed, five-year-old, that was referred to the Hospital of Veterinary Medicine, Federal University of Bahia, Brazil, with an increased volume in the orbital space, after enucleation for exophthalmia of unknown etiology. This animal was evaluated clinic and the diagnosis image (radiography and computed tomography) demonstrated a large formation of bone predominantly in the region of the right orbit and zygomatic arch, with invasion and destruction of adjacent bones. Due to her poor quality of life, the dog was submitted to euthanasia and after necropsy. On gross examination, an encapsulated nodular mass with an irregular surface, measuring 5.6 x 4.6 x 3.9 cm, was located in the right lateral skull, occupying the orbit with displacement of the zygomatic arch. The tumor was identified by histopathology as a malignant mesenchymal neoplasm, multilobular osteochondrosarcoma. Thus, differential diagnoses for exophthalmos should include cancers, including the multilobular osteocondrossarcoma.

Orbital tumors: operative and therapeutic strategies.

The term "orbital tumors" includes diverse benign or malignant space-occupying lesions of the orbit, often leading to dystopia of the eyeball, motility disturbances, diplopia, visual field defects, and sometimes a complete loss of vision. Removing these tumors in a limited surgical field is challenging. Therefore, the preservation of function is a primary concern. We retrospectively reviewed 671 patients with orbital tumors from October 1999 to June 2014. Diagnosis on referral, presenting symptoms, radiological records, histology of the primary tumor or orbital metastasis, and treatment choice were analyzed. Among the 671 orbital tumors, 40% were accessed anteriorly, 36% via an orbitotomy with temporary osteotomy, and 23.9% underwent an orbital exenteration. As an illustration of the operative strategies with subsequent reconstructions, a distinction was made among the main indication groups: (1) function-preserving therapy for retrobulbar tumors, (2) malignant tumors of the conjunctiva and the eyelids, (3) exenteration of the orbit and subsequent reconstruction, and (4) operative and therapeutic strategy for orbital metastases. Adequate preoperative use of modern imaging techniques and thorough planning of the operation are crucial. Accurate histopathological diagnosis is crucial for planning appropriate therapeutic and surgical interventions. New innovative treatment concepts and surgical techniques arise from the close cooperation of related disciplines such as ophthalmology and neurosurgery. Although an orbital exenteration in patients with eyelid and conjunctival carcinomas can now often be avoided, eye-preserving treatment for locally advanced carcinomas of the conjunctiva and eyelid must be attempted. For extensive orbital malignancies, orbital exenteration is curative. In this context, primary closure of the orbit can improve the patient's quality of life and avoid subsequent complications. Concerning orbital metastasis, early diagnosis can preserve function and fulfil the esthetic demands of the patients. In palliative tumor disease, operative procedures such as orbital decompression or tumor debulking can reduce patient complaints and contribute to improved quality of life.

Lymphoma of the ocular adnexa.

Over the last decades, the incidence of ocular adnexal lymphomas has been increasing. Over the last decade advances in the imaging of ocular adnexal lymphomas have enabled precise biopsies of the tumors. Biopsies are necessary for immunophenotyping, correct molecular classification and the immediate start of the appropriate treatment. In a retrospective study, we collected data from 16 patients (19 eyes) treated for lymphoma of the ocular adnexa between 2006 and 2011 with various tumor sites. We evaluated ocular symptoms of the patients in correlation to the tumor localization on imaging and determined the access of biopsy. Follow-up period (13.7 ± 15.4 months) and therapy were analyzed. The mean age of study patients was 67.4 ± 13.6 years. Seven patients presented with exophthalmos, 6 with upper lid swelling, 5 with double vision, 5 with reduced visual acuity and one patient with retinal detachment. None of the patients complained of pain. In 7 cases the location of the OAL was superior, in 6 retrobulbar, in 4 patients in the lacrimal gland (1 bilaterally affected), one case with lacrimal sac infiltration and another with isolated subconjunctival lymphoma. Patients with retrobulbar tumors complained of visual loss, whereas patients with anterior orbital tumors showed localized nodular swelling. In 11 cases (58%) the diagnosis was marginal zone B-cell lymphoma (MALT), in 5 (26%) follicular lymphoma. 11 patients (69%) received curative and one HIV-positive patient palliative radiation. Three patients were treated with systemic rituximab due to generalized lymphoma and one of them was complemented with CHOP therapy. One patient received chemotherapy alone (CHOP). During the follow-up the HIV-positive patient died. All our lymphoma patients showed full tumor regression, without side effects from radiotherapy. In this study we emphasize the need to perform a diagnostic biopsy. The risk of biopsy by a trained surgeon is small. Early and accurate diagnosis is crucial for proper treatment. In unclear situations repeated biopsies might be necessary.

RETROBULBARINIS PSEUDOTUMORAS DĖL SKRUOSTE UŽSILIKUSIO SMULKAUS METALINIO SVETIMKŪNIO: KLINIKINIO ATVEJO APRAŠYMAS IR LITERATŪROS APŽVALGA

Aim: to present a patient’s clinical case; to demonstrate how important is to suspect rertrobulbar pseudotumor timely, why it is necessary to remove even the smallest metal foreign bodies from the jaw area; to show the importance of an integrated simultaneous clinical delivery on the spot during the investigation of a complex illness. Case report: presenting the clinical case – patient MA (66 years of age) right eye vision started to deteriorate 6 years ago, a small defect of a pupil (abnormal pupil shape) was found; after the remove a cataract operation, the vision improved (during the week after the operation the patient has not used prescribed corticosteroid drops in the eye, this incompliance with prescription caused the uveitis anterior, which went away in 2 months after relevant treatment started). One year after surgery a pain appeared in the area of the right cheek, teeth and beneath the right eye, manifested hearing weakness dextra side. Several dentists treated this patient. Also rhinologist, mouth, face, jaw surgeons and oncologists were involved. Diagnosis: alveolitis, sinusitis, osteomielitis sinus maxilaris dextra, a foreign body in a right maxillary sinus projection. Patient was examined for TBC, sarcoidosis, fungal illness, syphilis, all with negate results. Gradually right eye became blind. After the vision of the left eye began to deteriorate, further cataract surgery was undertaken. The further sudden deterioration in the general condition of the patient was treated in the neurological and supportive therapy departments for several months. Diagnosis: cerebellar degeneration and chronic polyneuropathy ataxia, unspecified dementia, extraocular palsies, metabolic hepatitis, chronic pancreatitis, bladder disturbance. During that time a protrusion of the right eye gradually enlarged and became more exposed. The left eye became blind several months later. KT and MRT: right eye’s retrobulbar tumor spread through eyehole slots intracranial and to left orbit; a small metal foreign body was found subcutaneously in the right cheek. A biopsy was taken from the para- and retrobulbar tissues: fibromatosis was diagnosed. Half a year later a sphenoorbital meningioma was suspected and the surgery aimed to partially remove a tumor from the right orbit was performed. During this stay under the neurosurgeons care it becomes clear that episodes of psychomotor agitation were also present. The eyelids of the right eye were sutured to protect the cornea against perforation. Histologic diagnosis: retrobulbar pseudotumor of both eyes. Metal foreign body remained untouched. The ophthalmologist removed the foreign metal body, which was situated in the cheek subcutaneously, close to N. infraorbitalis with capsule in a local polyclinic soon afterwards. The composition of the foreign metal object was investigated: it was found that 95% of it was iron with small amounts of rare metals usually found in steel alloy, calcium. Histology detected hemosiderosis in connective tissue of capsule. Patient was examined by a rheumatologist on the basis of the suspicion of Wegener granuliomatosis. Data to confirm Wegener’s granulomatosis was not enough; internal organs without lesions, it was diagnosed cholelithiasis and fibrotic lesions in the lungs. It was confirmed systemic transgression of connective tissue with retrobulbar pseudotumor diagnosis. Corticosteroid treatment was given for 1 month. Patient was examined 8, 15 and 27 month after foreign body removal later: the skin of the face was free of scars, eyelids of the right eye has been sutured; the left eye had no inflammation, refracto- and keratometry findings were the same, like 4 years before; levels of immunoglobulins G and E in blood decreased - normal; the systemic transgression of connective tissue remained. Patient walks with a wide-based gait, he becames totally dependent on care (he is blind and desorientated at place and time, his personality has changed; Mini Mental State Examination 13/30). This story showed, how it is important to have a complete understanding of the patients health from various medical specialists at the same physical place and at the same time. The case shows surprising differences of results of radiologic examination of the same case.

The Transconjunctival Approach a Minimally Invasive Approach to Various Kinds of Retrobulbar Tumors

Orbital tumors, particularly those within the retrobulbar space, were approached by maxillofacial, ophthalmic, and neurological surgeons. Less traumatic approaches in this functionally and cosmetically important region are desirable. We describe another method to remove orbital tumor in the retrobulbar space by a transconjunctival approach with lateral canthotomy and transient extraocular muscle severing without lateral orbitotomy. We report 5 retrobulbar tumors operated with a transconjunctival approach, 2 of which were intraconal. Contrast-enhanced computed tomography and magnetic resonance imaging scans were used to determine precise location of the retrobulbar tumor. Retrobulbar tumors could be removed successfully through a transconjunctival approach. Three pleomorphic adenomas, 1 carvenous hemangioma, and 1 pseudotumor were the pathologic findings encountered. These patients were free from visible scars, proptosis, and any other noticeable complications at last follow-up, 6 months after surgery. The transconjunctival approach, which involves lateral canthotomy and transient extraocular muscle severing without lateral orbitotomy, is an unconventional procedure for retrobulbar tumor and results in a successful outcome. The indications for this approach depend on the size, location, and nature of the tumor. In this regard, contrast-enhanced computed tomography and magnetic resonance imaging scans give useful information for planning operative strategy.

Retrobulbar primitive neuroectodermal tumor in a squirrel monkey (Saimiri sciureus)

A 2.8-year-old female captive-bred common squirrel monkey (Saimiri sciureus) showed exophthalmos of the right eye, and the eye was surgically enucleated. A tumor mass was found in the eye. Formalin-fixed tumor samples were examined histopathologically and immunohistochemically for diagnosis. The retrobulbar tumor mass adhered to the sclera and infiltrated the choroid. Histopathologically, tumor cells were pleomorphic, arranged in a sheet pattern, and mimicked primitive neuroectodermal cells. The tumor cells were strongly positive for precursor neuronal cell markers (beta III tubulin, neuron-specific enolase, vimentin, nestin, doublecortin, oligo2, and S-100), but negative for mature cell markers (cytokeratin, neurofilament, and glial fibrillary acidic protein) and a retinoblastoma marker (rhodopsin). This is the first reported case for the retrobulbar location of primitive neuroectodermal tumor in non-human primates.

Metastasis of hepatocellular carcinoma presented as a tumor of the maxillary sinus and retrobulbar tumor

Hepatocellular carcinoma (HCC) is the most frequent primary malignant tumor of the liver. It is usually seen in the 6th and 7th decades of life and chronic hepatitis B is the most frequent cause. Extrahepatic metastasis of HCC is an indicator of a poor prognosis and the most common sites are lungs, bones, lymph nodes, kidneys and adrenal glands. We reported a case of isolated metastasis in the right maxilla, which had been found initially, before the tumor in the liver was diagnosed. A 70-year-old man underwent dental surgery of the upper right molar. Prolonged bleeding control was difficult for up to two weeks, so the biopsy was performed. Histopathological analysis revealed a metastatic hepatocellular carcinoma. Computerized tomography (CT) of the abdomen revealed a diffusely heterogeneous liver parenchyma with irregular borders and two foci of mass lesions. There were metastasis in the spleen and also two pathological retroperitoneal lymph nodes were detected, but no ascit, liver cirrhosis, cholestasis or portal vein thrombosis were seen. CT of the orbital and maxillary regions revealed a tumor mass in the right maxillary sinus, spreading to the alveolar sinus, nasal cavity and partially infratemporal space. A tumor mass was in the right orbit as well, infiltrating the surrounding bones and muscles. Clinically, there was proptosis of the right eye accompanied by amaurosis. The treatment started with chemotherapy based on 5-fluorouracil (sorafenib was not available). After three cycles, control CTs showed a stable disease in the liver, but progression in the right maxillary sinus and orbit. Enucleation of the right eye was performed and postoperative radiotherapy was planed. The patient deteriorated rapidly and died, about 6 months after the disease had been diagnosed. Extrahepatic metastasis of HCC represents a progressive phase of the disease with poor prognosis, so the main aim of the treatment should be palliation and care of symptoms.

Clinical research of intraoperative image-guidance in endoscopic nasocular operation.

To evaluate the availability and our experience of intraoperative image-guidance in endoscopic nasocular operation. Seven cases of endoscopic nasal surgery with intraoperative image-guidance were retropectively reviewed, including 3 cases of optic nerve injury; 3 cases of foreign object of optic behind the eyeball; 1 case of retrobulbar tumor (angeioma). The preoperative preparatory time would take 15 minutes, including coordination, head holder localization, conventional instrument registration. In our cases, the localization accuracy between 3-D image landmarks of navigation system and actual anatomical landmarks was less than 1.3mm. The optic nerve and other anatomical points could be orientated accurately in intraoperative procedures. No complication occurred. Nasal endoscope combined with image-guidance systems provides accurate anatomical localization of anterior skull base with enlarged operation field. It is possible for surgeons to observe important anatomical structures during endoscopic surgery. It could increase the effectiveness and decrease surgical complications, especially in complicated cases.

Signalment and Clinical Complaints Initiating Hospital Admission, Methods of Diagnosis, and Pathological Findings Associated with Bovine Lymphosarcoma (112 Cases)

Lymphosarcoma in adult cattle has multiple manifestations. To describe the signalment, clinical complaints, and tumor location, and to evaluate utility of diagnostic tests in cattle with lymphosarcoma. Adult cattle admitted to Cornell University between January 1980 and December 2008 with a definitive diagnosis of lymphosarcoma. Retrospective case study was conducted with a search of all medical records at Cornell University for cattle diagnosed with lymphosarcoma. Categorical data were analyzed with a Wilcoxon rank-sum tests. Sensitivities of diagnostic tests were calculated. There were 106 cows and 6 bulls (median age 5 years) examined for anorexia (34%), weight loss (16%), and fever (14%). The sensitivities of antemortem diagnostic tests performed were peripheral lymph node (PLN) wedge biopsy, 100%; surgical exploration and biopsy, 100%; pleurocentesis, 80%; pericardiocentesis, 67%; PLN fine-needle aspirate, 41%; abdominocentesis, 33%; and cerebral spinal fluid tap, 19%. Median peripheral blood lymphocyte count was 4,900 cells/muL, 10% of cattle were leukemic and 25% had lymphocytosis according to the Bendixen Key. The most frequently identified tumor locations (% of cattle) were the heart (66%), abomasum (61%), uterus (38%), kidney (32%), and epidural space (26%). Predilection sites were similar to previously reports but we found a higher incidence of renal tumors and lower incidence of retrobulbar tumors. Knowledge of common clinical presentations, organ involvement, and sensitivities of diagnostic tests will aid informed decisions on the most appropriate tests and interpretation of their results in clinical cases of bovine lymphosarcoma.

Misdiagnosis of Peripapillary Staphyloma as Retrobulbar Tumour: A Case Report

We describe a 10-year-old Chinese girl with blurred vision in her left eye over a month and an optic nerve “mass” of her left orbit shown on computed tomography. The patient was initially misdiagnosed as having a retrobulbar tumour. However, detailed fundus examination showed a very deep excavation surrounding the disc and magnetic resonance imaging revealed excavation of the posterior wall connected to the vitreous cavity. These findings suggested a diagnosis of peripapillary staphyloma. The reasons for the misdiagnosis are discussed.

2531: Local Radiation Therapy Alone for Marginal Zone B-Cell Lymphoma Confined to the Orbit

2531: Local Radiation Therapy Alone for Marginal Zone B-Cell Lymphoma Confined to the Orbit

Retrobulbäre Metastase als klinische Erstmanifestation eines Mammakarzinoms - ein interdisziplinäres Problem

From the gynecologic point of view ocular metastases are uncommon and mostly unknown, while malignancies of the breast are the most common primary tumor when metastases are found in the eye. Even more unknown is the fact that in 3% of breast cancer cases the first clinical manifestation is a tumor in the eye [1]. We describe the case of a 64-year-old woman who has been treated by her ophthalmologists for increasing motility disorders of the eye. The woman had a known endocrinologic orbitopathy. The worsening of her symptoms was at first associated with the endocrinologic orbitopathy. But the initiated corticoid treatment did not improve the symptoms: they even worsened. Subsequently further diagnostic tests were done in the course of which a retrobulbar tumor was diagnosed. The histology suggested the primary tumor was breast cancer. The described procedures took one year, after which the woman was referred to the gynaecological department, where a mammography led to the final diagnosis of breast cancer. Due to the high incidence of breast cancer the total number of women who first see an ophthalmologist for vision problems caused by a tumor in the eye is not negligible. This shows that both sides - the gynecologists and ophthalmologists - should be sensitised to the fact that the primary ofany tumor of the eye can be breast cancer, in order to direct treatment more quickly to the cause of the cancer, thus leading to a better curative success.

Retrobulbar Rhabdomyosarcoma in a Hovawart

Neaas A. , P. Rau‰er , F. Tich , P. Kohout , H. Kecova : Retrobulbar Rhabdomyosarcoma in a Hovawart. Acta Vet. Brno 2003, 72: 399-404. This clinical case study describes a three-year-old female Hovawart dog presented due to a unilateral exophtalmos and diagnosed with a retrobulbar tumour arising from m. rectus ventralis using ultrasound and computer tomography. The tumour was cytologically classified to be of a malignant mesenchymal kind. Modification of lateral orbitotomy with canthotomy was performed and the circumscribed tumour resected in its entirety. After healing, the eye was like the healthy contralateral one. Three months later, however, there was a relapse of the same extent and the patient was euthanised on the owner s request. Rhabdomyosarcoma was confirmed by repeated histological examinations. Tumour, dog, orbitotomy Retrobulbar processes belong to relatively frequent ophthalmological problems of dogs and cats. Apart from inflammatory lesions (abscesses, cellulitis), there are frequently processes of neoplastic origin such as primary or metastatic tumours (Spiess and Wall inHakanson 1999). Kern (1985) mentioned up to 74% of retrobulbar tumours to be of metastatic origin. Cases of retrobulbar tumours are very often malignant. Manson et al. (2001), Kern (1985), and Hendrix and Gelat t (2000) report 42%, 91%, and even up to 95% of malignant tumours, respectively. A total of 21 different retrobulbar neoplasia was described with osteosarcomas, fibrosarcomas and nasal adenocarcinomas (cf. Table) being the most frequent ones. There is one reported case of a retrobulbar rhabdomyosarcoma (Hendrix and Gelat t 2000). No age and breed predisposition of the occurrence of retrobulbar tumours was found (Attal i-Soussay et al. 2001). The mean age, however, is relatively high; i.e., 8.4 and 10.7 years reported by Hendrix and Gelat t (2000) and Attal iSoussay et al. (2001), respectively. Kern (1985) mentions purebred dogs, mostly females of middle age, to be typically affected. Prognosis of cases of retrobulbar neoplasia is generally poor with low survival of patients. Attal i-Soussay et al. (2001) mention that dogs survive for up to 10 months. According to Hendrix and Gelat t (2000) 86% and 19% of dogs live longer than 6 and 12 months, respectively. Radical treatment accompanied by a partial or total orbitectomy decreases the relapse of tumours to 36.7%. More than 70% of patients then survive for a period longer than one year (O Brien et al. 1996). According to At ta l i -Soussay et al. (2001) clinical signs often encountered include exophthalmos (84%), conjunctival hyperaemia (40%), third eyelid prolapse (28%), exposure keratitis (20%) and anomalies of the fundus (20%). Barnet and Grimmes (1972) mention the occurrence of retinal detachment. When the tumour affects the nerve tissue, there may be progressive neurological signs (Andrew 1999). Radiographs often show osteolysis (Mason et al. 2001). Retrobulbar tumours may form metastases, for ACTA VET. BRNO 2003, 72: 399–404 Address for correspondence: Doc. MVDr. Alois Neaas, Ph.D Department of Surgery and Orthopaedics University of Veterinary and Pharmaceutical Sciences Palackeho 1-3, 612 42 Brno, Czech Republic Phone: +420 602 742 484 Fax: +420 541 562 344 E-mail: necas@eurosat.cz http://www.vfu.cz/acta-vet/actavet.htm example, to the lung tissue with subsequent relevant clinical problems (Mart in et al. 2000). Resection of tumours is the treatment of choice. There is a better prognosis when the resection is accompanied by a partial or total orbitectomy (O Brien et al. 1996). For the proper resection of retrobulbar tumours a lateral (Spiess and Wall in-Hakanson 1999) or modified orbitotomy (Gilger et al. 1994) is often necessary.