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Congenital proptosis secondary to orbital teratoma. Clinicopathological study
Proptosis congénita secundaria a teratoma orbitario. Estudio clinicopatológico
P. Grube-Pagola
, R.I. Hobart-Hernández, M.A. Martínez-Hernández, S.M. Gómez-Dorantes, G. Alderete-Vázquez
Corresponding author
Departamentos de Oftalmología, Oncología Pediátrica y Patología, Hospital General de Veracruz, Veracruz, Mexico
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"apellidos" => "Ayuso" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S036566911200384X" "doi" => "10.1016/j.oftal.2012.07.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S036566911200384X?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579413000625?idApp=UINPBA00004N" "url" => "/21735794/0000008800000004/v1_201306181844/S2173579413000625/v1_201306181844/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Congenital proptosis secondary to orbital teratoma. Clinicopathological study" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "153" "paginaFinal" => "156" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "P. Grube-Pagola, R.I. Hobart-Hernández, M.A. Martínez-Hernández, S.M. Gómez-Dorantes, G. Alderete-Vázquez" "autores" => array:5 [ 0 => array:4 [ "nombre" => "P." "apellidos" => "Grube-Pagola" "email" => array:1 [ 0 => "Grubejr78@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "R.I." "apellidos" => "Hobart-Hernández" ] 2 => array:2 [ "nombre" => "M.A." "apellidos" => "Martínez-Hernández" ] 3 => array:2 [ "nombre" => "S.M." "apellidos" => "Gómez-Dorantes" ] 4 => array:2 [ "nombre" => "G." "apellidos" => "Alderete-Vázquez" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Departamentos de Oftalmología, Oncología Pediátrica y Patología, Hospital General de Veracruz, Veracruz, Mexico" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Proptosis congénita secundaria a teratoma orbitario. Estudio clinicopatológico" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 821 "Ancho" => 1230 "Tamanyo" => 124692 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Computerized axial tomography image shows a heterogeneous right side retro-orbitary tumor with cystic and solid areas and anterior ocular globe displacement.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Congenital orbital teratoma is an infrequent tumor that originates in the germinal cells which have escaped the influence of organization in early embryo development.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The most frequent location of teratomas is the gonads, although they can also be observed in the sacrococcygeal and retroperitoneal region. Mature teratomas are tumors comprising a combination of mature tissue which are characteristic of the 3 germinal layers. The tumors that only exhibit elements of one or 2 germinal layers are choristomas or teratoid tumors respectively.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Case report</span><p id="par0010" class="elsevierStylePara elsevierViewall">A newborn male with right proptosis secondary to retro-orbitary tumor was admitted. Ophthalmological physical exploration revealed perforated corneal ulcer, iris hernia, complete ophthalmoplegia, chemosis and palpebral retraction (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Computerized tomography revealed a heterogeneous retro-orbitary tumor with cystic and solid areas limited to the orbit with bone reshaping (<a class="elsevierStyleCrossRefs" href="#fig0010">Figs. 2 and 3</a>). Complete extraction of the tumor was performed with ocular globe enucleation without peri-surgery complications. The tumor was sent for histopathological study.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Macroscopically, the tumor was ovoid and of yellowish coffee color with a size of 4.7<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>3<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>3<span class="elsevierStyleHsp" style=""></span>cm. Serial sections revealed a heterogeneous and predominantly solid shiny yellow surface with fatty appearance in addition to small, condroid-looking pearly white areas. In addition, the tumor exhibited small clayish cysts with greenish-yellowish mucus and white lumpy material (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>). Numerous histological sections were made which in the solid areas exhibited fatty tissue, bone, cartilage, neuroepithelium areas with ganglion cells and choroidal plexus (<a class="elsevierStyleCrossRef" href="#fig0025">Fig. 5</a>). The cystic areas were covered with keratinizing stratified flat epithelium similar to epidermis as well as cilliated pseudostratified column epithelium producing respiratory-type mucus (<a class="elsevierStyleCrossRef" href="#fig0030">Fig. 6</a>). No immature or malign tissue was observed. The histopathological diagnostic was mature teratoma.</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><elsevierMultimedia ident="fig0025"></elsevierMultimedia><elsevierMultimedia ident="fig0030"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">After 18 months in follow-up the patient did not exhibit recurrence of the lesion.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discussion</span><p id="par0025" class="elsevierStylePara elsevierViewall">Congenital orbit teratomas are rare lesions. Bibliographic reviews refer a slight predominance of the left orbit (60%) and a ratio of 2 to 1 of female patients. Typically, the tumor presents with rapid growth, unilateral proptosis and palpebral retraction without intracranial involvement. Generally, the ocular globe is displaced forward and exhibits degenerative changes secondary to the tumor. In these cases, the orbit exhibits an increase of up to 3 times its size.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">At the histological level, congenital teratomas are predominantly benign with mature tissue originated in the ectoderm (flat stratified epithelium, cutaneous annexes), neuroectoderm (glyal tissue, choroidal plexus, ganglion cells), mesoderm (smooth muscle, fatty tissue, bone and cartilage) and less frequently the endoderm (respiratory and gastrointestinal epithelium).<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,4</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Very few malign teratoma cases have been published and most correspond to mixed germinal tumors (teratoma with seminoma, embryo carcinoma or endoderm sinus tumor), teratomas with non-germinal malign tumors (sarcoma, neuroblastoma) and immature teratomas.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> The treatment of choice is tumor resection with ocular globe exenteration and preservation of eyelids. However, when the ocular globe is intact conservative surgery should be carried out.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">The present case is a newborn male which exhibited a very rare congenital tumor located in the right orbit. For this reason the authors deemed it important to report it. In the presence of a retro-orbitary congenital tumor teratoma must be taken into account in the differential diagnostic. Even though this case did not exhibit malign or immature elements, the histological study must include multiple histological sections of the tumor for adequate study and classification.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflict of interests</span><p id="par0045" class="elsevierStylePara elsevierViewall">No conflict of interest has been declared by the authors.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:2 [ "identificador" => "xres190822" "titulo" => array:3 [ 0 => "Abstract" 1 => "Case report" 2 => "Discussion" ] ] 1 => array:2 [ "identificador" => "xpalclavsec178286" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres190823" "titulo" => array:3 [ 0 => "Resumen" 1 => "Caso clínico" 2 => "Discusión" ] ] 3 => array:2 [ "identificador" => "xpalclavsec178285" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Case report" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Conflict of interests" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2011-07-27" "fechaAceptado" => "2012-04-08" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec178286" "palabras" => array:3 [ 0 => "Teratoma" 1 => "Congenital" 2 => "Orbital" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec178285" "palabras" => array:3 [ 0 => "Teratoma" 1 => "Congénito" 2 => "Órbita" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Case report</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A newborn male with right proptosis secondary to a retroocular mass was admitted. Ophthalmological examination also showed corneal ulcer and perforation, iris hernia, total ophthalmoplegia, chemosis and eyelid retraction. The histopathology diagnosis was mature teratoma.</p> <span class="elsevierStyleSectionTitle">Discussion</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Teratomas are tumors composed of a mixture of mature tissues consisting of 3 germ layers. Congenital teratomas of the orbit are very rare and should be included as a possibility in cases with a primary tumor in the orbit.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Caso clínico</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Recién nacido masculino con proptosis secundaria a tumor retroorbitario. La exploración oftalmológica mostró úlcera corneal, perforación, hernia del iris, oftalmoplejia y retracción palpebral. Se realizó estudio anatomopatológico con diagnóstico de teratoma maduro.</p> <span class="elsevierStyleSectionTitle">Discusión</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El teratoma congénito maduro es una neoplasia germinal con presencia de elementos maduros de las tres capas germinales. Es una lesión poco frecuente en la órbita que debe ser incluida en los diagnósticos diferenciales cuando se encuentra un tumor retroorbitario congénito.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Grube-Pagola P, et al. Proptosis congénita secundaria a teratoma orbitario. Estudio clinicopatológico. Arch Soc Esp Oftalmol. 2013;88:153–6.</p>" ] ] "multimedia" => array:6 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 938 "Ancho" => 900 "Tamanyo" => 104464 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Clinical appearance of the patient with massive right side proptosis.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 821 "Ancho" => 1230 "Tamanyo" => 124692 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Computerized axial tomography image shows a heterogeneous right side retro-orbitary tumor with cystic and solid areas and anterior ocular globe displacement.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 908 "Ancho" => 1048 "Tamanyo" => 151164 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Tomographic reconstruction evidencing significant reshaping of the orbitary bone structure.</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Fig. 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 841 "Ancho" => 1215 "Tamanyo" => 114923 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Macroscopic appearance of the tumor section surface.</p>" ] ] 4 => array:7 [ "identificador" => "fig0025" "etiqueta" => "Fig. 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 974 "Ancho" => 1322 "Tamanyo" => 335137 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Micro photographs showing various mature tissue (hematoxylin and eosin): (a) trabecular bone (10×) and (b) pigmented neuroepithelium and ganglion cells (40×).</p>" ] ] 5 => array:7 [ "identificador" => "fig0030" "etiqueta" => "Fig. 6" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr6.jpeg" "Alto" => 1061 "Ancho" => 1423 "Tamanyo" => 378859 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Micro photographs showing mature tissue (hematoxylin and eosin): (a) keratinizing stratified flat epithelium and skin annexes (20×) and (b) respiratory cartilage and epithelium (10×).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prenatally detected congenital orbital teratoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Y.J. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2023 March | 2 | 2 | 4 |
| 2018 February | 28 | 0 | 28 |
| 2018 January | 43 | 0 | 43 |
| 2017 December | 21 | 2 | 23 |
| 2017 November | 33 | 2 | 35 |
| 2017 October | 48 | 1 | 49 |
| 2017 September | 59 | 3 | 62 |
| 2017 August | 40 | 4 | 44 |
| 2017 July | 57 | 6 | 63 |
| 2017 June | 100 | 3 | 103 |
| 2017 May | 113 | 9 | 122 |
| 2017 April | 57 | 5 | 62 |
| 2017 March | 116 | 41 | 157 |
| 2017 February | 167 | 3 | 170 |
| 2017 January | 78 | 1 | 79 |
| 2016 December | 79 | 4 | 83 |
| 2016 November | 104 | 10 | 114 |
| 2016 October | 161 | 15 | 176 |
| 2016 September | 179 | 4 | 183 |
| 2016 August | 105 | 3 | 108 |
| 2016 July | 72 | 1 | 73 |
| 2016 June | 99 | 17 | 116 |
| 2016 May | 93 | 13 | 106 |
| 2016 April | 88 | 13 | 101 |
| 2016 March | 103 | 16 | 119 |
| 2016 February | 102 | 25 | 127 |
| 2016 January | 86 | 16 | 102 |
| 2015 December | 76 | 18 | 94 |
| 2015 November | 80 | 14 | 94 |
| 2015 October | 112 | 23 | 135 |
| 2015 September | 73 | 7 | 80 |
| 2015 August | 88 | 19 | 107 |
| 2015 July | 127 | 14 | 141 |
| 2015 June | 35 | 17 | 52 |
| 2015 May | 63 | 23 | 86 |
| 2015 April | 124 | 20 | 144 |
| 2015 March | 100 | 5 | 105 |
| 2015 February | 20 | 4 | 24 |
| 2015 January | 22 | 2 | 24 |
| 2014 December | 36 | 12 | 48 |
| 2014 November | 24 | 2 | 26 |
| 2014 October | 38 | 8 | 46 |
| 2014 September | 36 | 6 | 42 |
| 2014 August | 28 | 6 | 34 |
| 2014 July | 26 | 3 | 29 |
| 2014 June | 13 | 0 | 13 |
| 2014 May | 13 | 2 | 15 |
| 2014 April | 13 | 5 | 18 |
| 2014 March | 32 | 5 | 37 |
| 2014 February | 21 | 5 | 26 |
| 2014 January | 21 | 2 | 23 |
| 2013 December | 20 | 4 | 24 |
| 2013 November | 32 | 5 | 37 |
| 2013 October | 32 | 8 | 40 |
| 2013 September | 1 | 1 | 2 |
| 2013 July | 1 | 0 | 1 |
| 2013 June | 3 | 1 | 4 |
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