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Surgical Excision of Orbital Cysticercosis Lodged in Superior Oblique Muscle: Clinical Case Report.

Ding J, Zhao H, Lin J - Medicine (Baltimore) (2015)

Bottom Line: The main symptom of the patient was recurring history of painless orbital swelling and double vision in upgaze.Ocular motility examination revealed a restriction of the right eye in levoelevation.A contrast-enhanced computed tomographic scan of the orbit revealed the presence of a well-defined hypodense cystic lesion within the right superior oblique muscle.The patient was diagnosed with orbital space-occupying mass with acquired Brown syndrome.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Ophthalmology (JD, HZ); and Department of Oncology (JL), Tianjin Eye Hospital, Clinical College of Ophthalmology, Tianjin Medical University, Tianjin Key Laboratory of Ophthalmology and Vision Science, Tianjin, China.

ABSTRACT
Ocular cysticercosis refers to parasitic infections in humans. Most cases were treated by medicine. The case we reviewed was rarely reported with successful surgical intervention treatment.This case report describes a patient with cysticercosis existing in superior oblique tendon. The main symptom of the patient was recurring history of painless orbital swelling and double vision in upgaze. Ocular motility examination revealed a restriction of the right eye in levoelevation. A contrast-enhanced computed tomographic scan of the orbit revealed the presence of a well-defined hypodense cystic lesion within the right superior oblique muscle.The patient was diagnosed with orbital space-occupying mass with acquired Brown syndrome. Surgical exploration of the superior oblique muscle was performed, and the cyst was removed from the eye and confirmed by histopathological examination. After surgery, an ocular motility examination revealed orthotropia in the primary position and downgaze, with mild restriction in levoelevation.Surgical removal could substitute for medical therapy when the cysticercosis is lodged in the superior oblique muscle, although, prior to surgery, important factors, such as patient requirements, surgical skills of the surgeon, and cyst placement, should be considered.

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Histopathology of the cyst.
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Figure 5: Histopathology of the cyst.

Mentions: Surgical excision of the superior oblique muscle was performed under general anesthesia. Incisions that extended 1.5 cm to the lateral canthus were first made to widen the nasal side and to release soft tissue. Exploration was started through conjunctival (superior nasal fornix) incision. During surgical exploration of the superior oblique muscle, a swollen tendon came to view. The cyst flew from the tendon when the sheath was cut for almost 5 mm along the tendon (Figure 4). Pathological findings indicate a 25 mm of moderately firm pink–gray mass. The mass had cystic microscopic features, as confirmed through histopathological examination (Figure 5).


Surgical Excision of Orbital Cysticercosis Lodged in Superior Oblique Muscle: Clinical Case Report.

Ding J, Zhao H, Lin J - Medicine (Baltimore) (2015)

Histopathology of the cyst.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4554119&req=5

Figure 5: Histopathology of the cyst.
Mentions: Surgical excision of the superior oblique muscle was performed under general anesthesia. Incisions that extended 1.5 cm to the lateral canthus were first made to widen the nasal side and to release soft tissue. Exploration was started through conjunctival (superior nasal fornix) incision. During surgical exploration of the superior oblique muscle, a swollen tendon came to view. The cyst flew from the tendon when the sheath was cut for almost 5 mm along the tendon (Figure 4). Pathological findings indicate a 25 mm of moderately firm pink–gray mass. The mass had cystic microscopic features, as confirmed through histopathological examination (Figure 5).

Bottom Line: The main symptom of the patient was recurring history of painless orbital swelling and double vision in upgaze.Ocular motility examination revealed a restriction of the right eye in levoelevation.A contrast-enhanced computed tomographic scan of the orbit revealed the presence of a well-defined hypodense cystic lesion within the right superior oblique muscle.The patient was diagnosed with orbital space-occupying mass with acquired Brown syndrome.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Ophthalmology (JD, HZ); and Department of Oncology (JL), Tianjin Eye Hospital, Clinical College of Ophthalmology, Tianjin Medical University, Tianjin Key Laboratory of Ophthalmology and Vision Science, Tianjin, China.

ABSTRACT
Ocular cysticercosis refers to parasitic infections in humans. Most cases were treated by medicine. The case we reviewed was rarely reported with successful surgical intervention treatment.This case report describes a patient with cysticercosis existing in superior oblique tendon. The main symptom of the patient was recurring history of painless orbital swelling and double vision in upgaze. Ocular motility examination revealed a restriction of the right eye in levoelevation. A contrast-enhanced computed tomographic scan of the orbit revealed the presence of a well-defined hypodense cystic lesion within the right superior oblique muscle.The patient was diagnosed with orbital space-occupying mass with acquired Brown syndrome. Surgical exploration of the superior oblique muscle was performed, and the cyst was removed from the eye and confirmed by histopathological examination. After surgery, an ocular motility examination revealed orthotropia in the primary position and downgaze, with mild restriction in levoelevation.Surgical removal could substitute for medical therapy when the cysticercosis is lodged in the superior oblique muscle, although, prior to surgery, important factors, such as patient requirements, surgical skills of the surgeon, and cyst placement, should be considered.

Show MeSH
Related in: MedlinePlus