Table of Contents - PAO Annual Meeting 2012

Results: The patient presented with a non-healing, spreading
wound that involved the central forehead, medial right and
left eyelids, nose and both mid-cheek areas. CT scan showed
irregular shaped superficial soft tissue mass involving the skin and
subcutaneous fat of both naso-glabellar and pre-maxillary areas.
Previous biopsy revealed Basosquamous carcinoma. Patient
underwent wide excision with 5mm clearance and rush frozen
section for control of margins of resection. Permanent medial
tarsorrhapy done and the rest left to granulate. Reconstruction
to be done later.
Conclusion: Early treatment of Basosquamous Carcinoma will
prevent its local destructive effect. Surgery with margin control
can offer cure for these patients.
Key Words: wide excision, neglected Filipino, basosquamous
carcinoma, basosquamous, carcinoma, midface
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A Case Report on an Unusual Intraorbital Foreign Body
Jessica Guzman, Fatima G. Regala, Charmaine Y. Ang
DOH Eye Center, East Avenue Medical Center, Philippines
Objective: To present a case of an orbital trauma, producing an
unusual intraorbital foreign body with no globe involvement.
Methods: This is a case report on an 18 year-old male with an
intraorbital toothbrush extending to the nasal cavity. He presented
with an embedded handle in the right orbit associated with
periorbital swelling. Initial visual acuity was OD 20/80 improved to
20/32-2 by pinhole, with commotio retinae and limited extraocular
muscle movement in all gazes. He underwent removal of the
toothbrush head, repair of inferior oblique and upper tarsus.
Reinsertion of levator aponeurosis into the tarsal plate and repair
of lid margin were also done. Intraoperative findings revealed that
the toothbrush went through the medial wall into the nasal cavity
with transection of the inferior oblique, levator aponeurosis and
upper lid margin.
Results: A 6cm by 1cm toothbrush with intact bristles was
removed from the wound. The swab specimen revealed moderate
growth of Enterobacter species. The patient was maintained on
topical antibiotics, intravenous antibiotics for 3 days then oral
antibiotics for 7 days. Visual acuity improved with resolution
of commotio retinae. Improvements in extraocular muscle
movements were observed, however there was residual ptosis.
Conclusion: Intraorbital foreign bodies are quite uncommon,
especially those with no globe involvement. Imaging is needed
prior to planning the removal of intraorbital foreign body to assess
the exact location. Indications for removing an intraorbital foreign
body include the nature of the foreign body and wound exposure.
Antibiotic coverage is important to prevent secondary infections.
Key Words: intraorbital foreign body
PP-31
Bilateral Proptosis with Visual Loss: A Case Report
J. Rotsen Evaristo, Fatima G. Regala
DOH Eye Center, East Avenue Medical Center, Philippines
Objective: To report a case of chronic bilateral proptosis with
visual loss.
Methods: This is a descriptive case report of an 18-year-old
male presenting with bilateral proptosis and visual loss caused by
a tumor originating from the nasal cavity.
Results: Biopsy of the nasal mass revealed histopathologic
findings consistent with a nasal polyp.
Conclusion: This is a case presentation of a nasal mass which
extended intracranially, causing bilateral proptosis and visual
loss. A tissue biopsy of the mass revealed it was a nasal polyp,
however, the progression of signs and symptoms raises the
suspicion that a malignant process is involved.
Key Words: Bilateral, Visual loss
PP-32
Carcinosarcoma in a Newborn
Aimee C. Ng Tsai
DOH Eye Center, East Avenue Medical Center, Philippines
Objective: To describe a rare case of carcinosarcoma, probably
from a metastatic Wilm’s tumor.
Method: This is a case report.
Poster Presentations
Result: A newborn was noted to have a mass on the left eye
upon delivery and was subsequently referred to our institution
for evaluation. On initial consult at 4 days of age, a 3.5 x 3cm
bleeding, fungating mass with areas of hematoma was noted
arising from the conjunctiva. Initial impression was embryonal
conjunctival mass, to consider malignancy. Other physical
examination findings were normal except for the conjunctival
mass. There was rapidly progressive enlargement of the mass
accompanied by profuse bleeding. She subsequently underwent
examination under anesthesia, cryoexcision of conjunctival
mass, and lid repair. Intraoperatively, the mass was found to
be originating from the preseptal orbicularis muscle and was
therefore thought to be a rhabdomyosarcoma. A 70 x 50 x 40
mm3 tan-brown, encapsulated, lobulated, and smooth mass was
obtained. Histopathologic findings turned out to be consistent
with carcinosarcoma, rule out metastatic Wilm’s tumor. Contrastenhanced
cranial CT scan done post-operatively only showed soft
tissue thickening in the left eyelid. Patient is still for Nephrologic
work up and immunostaining.
Conclusion: Metastatic process can present with a conjunctival
mass and should be included in the differential diagnosis of such
masses.
Key Words: carcinosarcoma, embryonal tumor,
rhabdomyosarcoma, wilm’s tumor
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