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Answers: 2008 Series -  October 14, 2008 Lecture 12 of 53  NEXT»

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Case16A


Photos courtesy of: Carol L. Shields, M.D.
Used with permission. Not to be reproduced.

A 37-year-old white female presented for the management of a reddish lesion in the right eye. She had a history of recurrent breast infections and three episodes of stroke, the cause of which had remain unknown. Her best corrected vision was 20/400 in the right eye and 20/25 in the left eye. The left eye was within normal limits. Slit lamp photograph of the right eye is shown above.

1. What is your clinical diagnosis?

a -- conjunctival lymphangiectasias/ lymphangioma

2. Where else would you look for similar lesions?

b -- orbit

3. Which one of the following is not a treatment modality?

d -- plaque therapy

Above the lesion are conjunctival lymphangiectasia and these are dilated lymphatic channels with a mixture of clear fluid and blood inside. When the vascular lesion forms a distinct mass, it is called a lymphangioma. Quite commonly, the conjunctival component is a superficial extension of deep orbital lymphangioma. These lesions can be excised or cauterized and when these are extensive, carbon dioxide laser can debulk the tumor load.

REFERENCES:

1. Rootman J, Hay E, Graeb D, et al. Orbital adnexal lymphangiomas. A spectrum of
hemodynamically isolated vascular hamartomas. Ophthalmology 1986:93:1558- 1570.

2. Shields JA, Shields CL. Tumors of conjunctiva. In: Stephenson CM, ed. Ophthalmic
Plastic Reconstructive and Orbital surgery. Stoneham MA: Butterworth-Heineman:
1997:253-271



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