Table of Contents - PAO Annual Meeting 2012

Key Words: Mixed Hemangioma, Antero-medial Orbitotomy,
Cavernous Hemangioma
PP-24
Recurrent Orbital Inflammatory Disease in a Pediatric Patient
Jerica Paula D. Berdon, Ma. Donna D. Santiago
Far Eastern University-Nicanor Reyes Medical Foundation
Medical Center, Philippines
Objective: To present a case of an 8-year old female with
orbital inflammatory disease which presented as a mass on the
superolateral aspect of the orbit. There was no resolution using
standard steroid therapy, thus, excision biopsy was done through
a lateral orbitotomy with bone flap but with recurrence three
months postoperatively.
Methods: Physical and diagnostic examinations led to an initial
impression of orbital inflammatory disease. There was absence
of resolution of orbital signs and symptoms on steroid therapy.
Excision biopsy of orbital mass through a lateral orbitotomy with
bone flap, with frozen section, was done.
Results: Excision biopsy revealed an irregular reddish brown
mass which on histopathology showed a chronic inflammatory
process. Three months postoperatively, there was recurrence of
swelling of the left upper lid. Repeat Orbital CT scan revealed
an enhancing soft tissue mass that could be one or combination
of fibrosing tissue or recurrence. Review of the histopathologic
specimen was done for which the diagnosis of chronic
inflammatory disease was re-affirmed. The patient was referred
back to Pediatric service where steroid therapy was restarted.
Orbital inflammatory signs were noted to respond favorably to
steroid treatment.
Conclusion: Orbital diseases may be inflammatory or
non-inflammatory. Differentiating them is crucial to provide
appropriate treatment for our patients. A detailed history, followed
by a comprehensive physical examination and complimented
by appropriate radiological evaluation is the optimal approach
to arrive at the correct diagnosis. Surgical intervention should
be reserved for cases of orbital inflammatory disease where an
aggressive lesion or malignancy is being ruled out. The surgical
approach should provide optimal exposure while minimizing
perioperative morbidity.
Key Words: Pseudotumor, lateral orbitotomy, chronic
inflammation
PP-25
The Efficacy of Topical Mitomycin-C in the Prevention of
Recurrence of Conjunctival Squamous Cell Carcinoma in a
36-year Old Male
Kate Concepcion-Torio, Ma. Rachelle Katrina C. Solis
Jo Anne P. Hernandez
Cardinal Santos Medical Center, Philippines
Objective: To report a case of conjunctival squamous cell
carcinoma treated with Mitomycin C (MMC) 0.04% Post Excision
for Prevention of Tumor Recurrence.
Method: This a case report.
Results: A 36-year old male came for consult due to conjunctival
mass on the right eye. This was preceded 6 months ago with
conjunctival hyperemia with no accompanying pain, itchiness
or discharge. Two months after, with the persistence of the
hyperemia, there was note of limbal mass. He was then assessed
to have pterygium and was advised excision. Patient refused at
the time and sought consult in our institution. On examination,
visual acuity on the right is 20/25, on the left is 20/20. Anterior
segment was unremarkable except for a raised, pinkish,
conjunctival mass on the right eye with frond-like surface and
dilated vessels measuring about 4x4 mm extending 1 mm into
the temporal cornea. Patient underwent excision biopsy with
cryotherapy. Histopathology of the mass revealed squamous
cell carcinoma. A regimen of 4 times daily dosing of MMC 0.04%
for 3 weeks, then discontinued for 3 weeks, then restarted for
another 3 weeks, to complete 3 cycles was done postoperatively.
Patient then followed up closely every 2 weeks. After completion
of 3 cycles, there was no noted recurrence of the tumor and only
conjunctival hyperemia was the adverse effect observed. This,
however, disappeared upon discontinuation of the regimen.
Conclusion: Squamous cell carcinoma of the conjunctiva is a
slow growing tumor capable of extensive local tissue damage.
Treatment would include complete surgical excision with
cryotherapy. However, tumor recurrence is a concern. In this
case, topical MMC proved to be an effective surgical adjunct in
preventing its recurrence although longer period of follow up is
recommended for further observation of recurrence.
Key Words: Topical Mitomycin C, Conjunctival Mass, Excision
Biopsy, Cryotherapy
PP-26
Wide Excision of a Large Upper Lid Sebaceous Gland
Carcinoma with Reconstruction Using the Modified Cutler-
Beard Technique
Emerson Jay B. Molina, Alex U. Pisig,
Margarita Justine O. Bondoc, Jo Anne P. Hernandez
Cardinal Santos Medical Center, Philippines
Objective: To report a case of a large upper eyelid sebaceous
gland carcinoma, with subsequent reconstruction of the frozen
section-guided excision defect using the modified Cutler-Beard
procedure.
Methods: This is a case report.
Poster Presentations
Results: An 81-year old Filipino female presented with an
enlarging mass in the right upper eyelid. The lesion was noted
8 months prior to consultation at our department. External exam
on the left eye was unremarkable. Vision is 20/70 on the right
and 20/100 on the left eye, with BCVA 20/50 for both. She is
pseudophakic on both eyes, with the rest of the anterior segment
36