melphalan and Eyelid-Diseases

Topics: Amyloidosis; Antineoplastic Agents, Hormonal; Dexamethasone; Eyelid Diseases; Humans; Male; Melphalan; Middle Aged; Multiple Myeloma; Myeloablative Agonists; Prognosis

To describe treatment complications following intra-arterial chemotherapy (IAC) for retinoblastoma.. A retrospective interventional series of ophthalmic artery cannulation for IAC injection (3 planned sessions at 1-month intervals) was undertaken. Thirty-eight catheterizations of 17 eyes of 17 patients were performed from September 2008 to September 2010. Fluoroscopy of the ophthalmic artery was performed before and immediately after treatment. Heparin was given during the procedure and aspirin (40 mg) was given orally for 1 week. The treatment complications were determined.. Only 17 of 190 children were selected for treatment with IAC during this period. Following successful ophthalmic artery cannulation in 16 cases, there was no evidence of metastasis, stroke, brain injury, or persistent systemic toxic effects. Fluoroscopy demonstrated patent ophthalmic artery immediately before and after IAC injection in each case. Following therapy, orbital and adnexal findings at 1 month included eyelid edema (n = 13), blepharoptosis (n = 10), cilia loss (n = 1), and orbital congestion with temporary dysmotility (n = 12). These findings resolved within 6 months in all cases. Following therapy, vascular findings included ophthalmic artery stenosis (permanent in 3 cases, temporary in 1 case), confirmed on fluoroscopy in 3 cases. Concomitant central or branch retinal artery occlusion was noted (permanent in 2 cases, temporary in 1 case). Subtle retinal pigment epithelial mottling in 9 cases that slowly evolved to later-onset underlying choroidal atrophy in 5 cases was noted.. Treatment with IAC for retinoblastoma can lead to mild and severe short-term ocular complications, including eyelid edema as well as potentially blinding vascular obstruction. This procedure should be used with caution.

Topics: Antineoplastic Agents, Alkylating; Blepharoptosis; Catheterization; Chemotherapy, Cancer, Regional Perfusion; Child; Child, Preschool; Edema; Eyelid Diseases; Female; Fluorescein Angiography; Fluoroscopy; Humans; Infant; Injections, Intra-Arterial; Male; Melphalan; Ocular Motility Disorders; Ophthalmic Artery; Retinal Neoplasms; Retinoblastoma; Retrospective Studies

We present a case report of necrobiotic xanthogranuloma (NXG) in a 76-year-old Caucasian lady occurring as a nodule in a blepharoplasty scar. NXG is a rare histiocytic disease with progressive orbital and systemic features. Management options of excision biopsy or chemotherapy are discussed.

Topics: Aged; Biopsy, Needle; Cicatrix, Hypertrophic; Drug Therapy, Combination; Eyelid Diseases; Female; Follow-Up Studies; Granuloma; Humans; Immunohistochemistry; Melphalan; Necrobiotic Disorders; Orbital Diseases; Prednisolone; Recurrence; Risk Assessment; Treatment Outcome; Xanthomatosis