MyMedR

Spontaneous orbital haematoma in a scurvy child: A forgotten diagnosis

Cheah SC, Tang IP, Matthew TJH, Ooi MH, Husain S

Int J Pediatr Otorhinolaryngol, 2020 Oct;137:110224.

PMID: 32896344 DOI: 10.1016/j.ijporl.2020.110224

Spontaneous unilateral orbital haematoma in children is not common and very rarely caused by scurvy. Scurvy is a clinical syndrome with a spectrum of clinical manifestations due to severe prolonged vitamin C deficiency leading to impairment of collagen synthesis over skin, bone, teeth and blood vessels. This paper presents a unique case of a 7- year-old girl with learning difficulty who presented with spontaneous right proptosis due to scurvy. Imaging studies suggestive of intra- orbital extraconal haemorrhage. The child was treated with a higher than recommended dose of vitamin C initially in emergency situation. She responded well and discharged without complication. Spontaneous orbital haematoma due to scurvy is very rare with less than 10 cases published in literature. The present case should raise the awareness regarding this forgotten disease and importance of balance nutrition amongst children.

Matched MeSH terms: Exophthalmos/etiology*

Fulltext Proptosis presenting as a delayed sign of frontal extradural haematoma

Saiful MN, Azmi A, Saffari MH

Med J Malaysia, 2007 Jun;62(2):156-7.

PMID: 18705451 MyJurnal

We report a case of a young man who presented with proptosis as a delayed manifestation of a frontal extradural haematoma (EDH) following a minor head injury. A computed tomography (CT) of the brain done 72 hours after trauma revealed a large extradural haematoma in the right anterior cranial fossa with orbital roof fracture and subperiosteal clot extension into the orbital cavity. Right frontal craniotomy with evacuation of haematoma was done and the proptosis completely resolved after surgery. The clinical course, possible mechanism and management of the patient are discussed.

Matched MeSH terms: Exophthalmos/etiology*

Metastatic osteosarcoma of the ethmoid: an unusual cause of recurrent epistaxis and proptosis

Sharma HS, Reddy SC, Mohamad A, Kamal MZ, Halder D

J Laryngol Otol, 1996 Jul;110(7):676-8.

PMID: 8759546

Osteosarcoma is the most common primary malignant tumour of bone and it usually metastasises to the lung. In the nasal cavity metastatic disease is extremely rare. We describe a case of osteosarcoma presenting with recurrent epistaxis, and proptosis due to secondaries in the nasal cavity. To our knowledge such a case has not been reported previously in the available English literature.

Matched MeSH terms: Exophthalmos/etiology

Distraction osteogenesis in the surgical management of syndromic craniosynostosis: a comprehensive review of published papers

Al-Namnam NMN, Hariri F, Rahman ZAA

Br J Oral Maxillofac Surg, 2018 06;56(5):353-366.

PMID: 29661509 DOI: 10.1016/j.bjoms.2018.03.002

Our aim was to summarise current published evidence about the prognosis of various techniques of craniofacial distraction osteogenesis, particularly its indications, protocols, and complications. Published papers were acquired from online sources using the keywords "distraction osteogenesis", "Le Fort III", "monobloc", and "syndromic craniosynostosis" in combination with other keywords, such as "craniofacial deformity" and "midface". The search was confined to publications in English, and we followed the guidelines of the PRISMA statement. We found that deformity of the skull resulted mainly from Crouzon syndrome. Recently craniofacial distraction has been achieved by monobloc distraction osteogenesis using an external distraction device during childhood, while Le Fort III distraction osteogenesis was used in maturity. Craniofacial distraction was indicated primarily to correct increased intracranial pressure, exorbitism, and obstructive sleep apnoea in childhood, while midface hypoplasia was the main indication in maturity. Overall the most commonly reported complications were minor inflammatory reactions around the pins, and anticlockwise rotation when using external distraction systems. The mean amount of bony advancement was 12.3mm for an external device, 18.6mm for an internal device and 18.7mm when both external and internal devices were used. Treatment by craniofacial distraction must be validated by long-term studies as there adequate data are lacking, particularly about structural relapse and the assessment of function.

Matched MeSH terms: Exophthalmos/etiology

Late presentation of retinoblastoma in Malaysia

Menon BS, Alagaratnam J, Juraida E, Mohamed M, Ibrahim H, Naing NN

Pediatr Blood Cancer, 2009 Feb;52(2):215-7.

PMID: 18855905 DOI: 10.1002/pbc.21791

The aims of this study were to review the presenting features, treatment and outcome for Malaysian children with retinoblastoma currently.

Matched MeSH terms: Exophthalmos/etiology

Fulltext Proptosis: a rare presentation of metastatic renal cell carcinoma

Ho CC, Krishna KK, Praveen S, Goh EH, Lee BC, Zulkifli MZ

Med J Malaysia, 2010 Sep;65(3):229-30.

PMID: 21939176

We present a case of a middle-aged man who was incidentally found to have right renal solid mass while investigating for his left eye proptosis. Computerised tomography (CT) scan confirmed the diagnosis of renal cell carcinoma and the tumour was successfully excised via open surgery. The histopathology examination revealed the 10x7x8 cm mass to be a clear cell type renal cell carcinoma. The rare presentation of this metastatic renal cell carcinoma, its diagnosis and management will be discussed.

Matched MeSH terms: Exophthalmos/etiology

A prospective study of ocular manifestations in childhood acute leukaemia

Reddy SC, Menon BS

Acta Ophthalmol Scand, 1998 Dec;76(6):700-3.

PMID: 9881556

PURPOSE: To determine the prevalence of ocular manifestations in childhood acute leukaemia at the time of presentation.

METHODS: Eighty-two children with acute leukaemia were examined for ocular lesions within two days of diagnosis before starting chemotherapy. The detailed ocular examination of both eyes was carried out by the ophthalmologist irrespective of the presence or absence of eye symptoms in all cases.

RESULTS: Only 3 out of 82 children presented with eye symptoms (3.6%). However, ocular changes were found in 14 children (17%); ten with lymphoblastic and four with myeloid leukaemia. The ocular lesions observed were proptosis, intraretinal haemorrhages, white centered haemorrhages, cotton wool spots, macular haemorrhage, subhyaloid haemorrhage, vitreous haemorrhage, papilloedema, cortical blindness, sixth nerve palsy, and exudative retinal detachment with choroidal infiltration.

CONCLUSION: In view of the high prevalence of asymptomatic ocular lesions in childhood acute leukaemia, routine ophthalmic examination should be included as a part of evaluation at the time of diagnosis.

Matched MeSH terms: Exophthalmos/etiology

Fulltext Challenges in the management of massive intraorbital and hemifacial arteriovenous malformation as causing life-threatening epistaxis

Manuel AM, Kalimuthu S, Pathmanathan SS, Narayanan P, Zainal Abidin Z, Azmi K, et al.

Asian J Surg, 2017 Apr;40(2):158-162.

PMID: 24210537 DOI: 10.1016/j.asjsur.2013.09.011

Arteriovenous malformations are congenital lesions that may evolve with time and manifest in a plethora of presentations. They can occur as torrential epistaxis when it extensively involves the facial region. Multi-imaging modalities are available to assist in characterizing the structure of the lesion as well as its location and extent. This complex disease requires a multidisciplinary team approach with preoperative embolization and surgery. We present a rare cause of life-threatening epistaxis in a gentleman with a longstanding orbital and hemifacial arteriovenous malformation and discuss the complexities involved in its management.

Matched MeSH terms: Exophthalmos/etiology

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