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Dwight R Kulwin - One of the best experts on this subject based on the ideXlab platform.
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a case of primary adenocarcinoma of the Lacrimal Sac
Orbit, 2005Co-Authors: Paul A Brannan, Robert C Kersten, Susan Schneider, Dwight R KulwinAbstract:Purpose: To present a rare case of adenocarcinoma arising from the Lacrimal Sac. Design: Interventional case report. Methods: Report of a new case of primary Lacrimal Sac adenocarcinoma. Results: The clinical presentation, workup, surgical treatment and pathology of a case of adenocarcinoma of the Lacrimal Sac are described. Conclusion: Although very rare, these tumors should be in the differential diagnosis of any Lacrimal Sac mass, especially those presenting above the medial canthal tendon. Other common features include expressible blood from the punctum, lack of pain, and a history of chronic epiphora or intermittent dacryocystitis. Local destruction and metastatic spread can be prevented by a high index of suspicion and early intervention.
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routine histopathologic evaluation of the Lacrimal Sac during dacryocystorhinostomy how useful is it
Ophthalmology, 2002Co-Authors: Robert C Kersten, Francesco P Bernardini, Mohammad Moin, Diana Reeves, Dwight R KulwinAbstract:Abstract Objective To determine the usefulness of "routine" Lacrimal Sac biopsy to evaluate unsuspected neoplasm or systemic disease in patients with acquired nasoLacrimal duct obstruction. Design Noncomparative, interventional case series with histopathologic correlation. Participants Review of charts revealed histopathologic reports on 302 specimens from 258 patients who had undergone routine dacryocystorhinostomy for clinical acquired nasoLacrimal duct obstruction. Intervention Dacryocystorhinostomy (DCR) with histopathologic evaluation of Lacrimal Sac. Main outcome measures The following variables were extracted from the medical records: age, gender, presenting symptoms, history of predisposing conditions, Lacrimal system abnormalities noted before surgery, dye disappearance test, dacryocystogram or dacryoscintillogram, appearance of the Lacrimal Sac during surgery, and histopathologic report of the Lacrimal Sac specimen. Results Findings of histopathologic evaluation of 302 Lacrimal Sac specimens from 170 females and 88 males who had undergone routine DCR were reviewed. Evidence of systemic disease or neoplasia involving the Lacrimal Sac was present in 10 specimens. All 10 positive specimens had a grossly abnormal appearing Sac at the time of surgery (n = 8), a known preexisting history of systemic diseases (n = 6), or both. The remaining 292 specimens showed chronic inflammation, fibrosis, or normal mucosa. Conclusions Only patients with known preexisting systemic disease or a grossly abnormal Lacrimal Sac had "positive" histopathologic findings. We recommend that Lacrimal Sac biopsy in patients undergoing DCR should be performed only in those with a positive history for systemic disease or an abnormal-appearing Lacrimal Sac during surgery.
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Routine histopathologic evaluation of the Lacrimal Sac during dacryocystorhinostomy: how useful is it?
Ophthalmology, 2002Co-Authors: Francesco P Bernardini, Robert C Kersten, Mohammad Moin, Diana Reeves, Dwight R KulwinAbstract:Abstract Objective To determine the usefulness of "routine" Lacrimal Sac biopsy to evaluate unsuspected neoplasm or systemic disease in patients with acquired nasoLacrimal duct obstruction. Design Noncomparative, interventional case series with histopathologic correlation. Participants Review of charts revealed histopathologic reports on 302 specimens from 258 patients who had undergone routine dacryocystorhinostomy for clinical acquired nasoLacrimal duct obstruction. Intervention Dacryocystorhinostomy (DCR) with histopathologic evaluation of Lacrimal Sac. Main outcome measures The following variables were extracted from the medical records: age, gender, presenting symptoms, history of predisposing conditions, Lacrimal system abnormalities noted before surgery, dye disappearance test, dacryocystogram or dacryoscintillogram, appearance of the Lacrimal Sac during surgery, and histopathologic report of the Lacrimal Sac specimen. Results Findings of histopathologic evaluation of 302 Lacrimal Sac specimens from 170 females and 88 males who had undergone routine DCR were reviewed. Evidence of systemic disease or neoplasia involving the Lacrimal Sac was present in 10 specimens. All 10 positive specimens had a grossly abnormal appearing Sac at the time of surgery (n = 8), a known preexisting history of systemic diseases (n = 6), or both. The remaining 292 specimens showed chronic inflammation, fibrosis, or normal mucosa. Conclusions Only patients with known preexisting systemic disease or a grossly abnormal Lacrimal Sac had "positive" histopathologic findings. We recommend that Lacrimal Sac biopsy in patients undergoing DCR should be performed only in those with a positive history for systemic disease or an abnormal-appearing Lacrimal Sac during surgery.
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management of congenital Lacrimal Sac fistula
Archives of Ophthalmology, 1990Co-Authors: Lee D Birchansky, Robert C Kersten, Jeffrey A Nerad, Dwight R KulwinAbstract:• Fourteen patients who were treated for symptomatic congenital Lacrimal Sac fistula were retrospectively reviewed to evaluate surgical success. Excision of the fistula alone was performed on 9 patients and excision with nasoLacrimal intubation on 5 patients (to our knowledge, the latter has not been previously described in the English literature). None of the 14 patients were symptomatic postoperatively during a mean follow-up of 16 months, with a range from 3 to 39 months. We conclude that dacryocystorhinostomy is usually not necessary to successfully treat symptomatic congenital Lacrimal Sac fistula.
Robert C Kersten - One of the best experts on this subject based on the ideXlab platform.
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a case of primary adenocarcinoma of the Lacrimal Sac
Orbit, 2005Co-Authors: Paul A Brannan, Robert C Kersten, Susan Schneider, Dwight R KulwinAbstract:Purpose: To present a rare case of adenocarcinoma arising from the Lacrimal Sac. Design: Interventional case report. Methods: Report of a new case of primary Lacrimal Sac adenocarcinoma. Results: The clinical presentation, workup, surgical treatment and pathology of a case of adenocarcinoma of the Lacrimal Sac are described. Conclusion: Although very rare, these tumors should be in the differential diagnosis of any Lacrimal Sac mass, especially those presenting above the medial canthal tendon. Other common features include expressible blood from the punctum, lack of pain, and a history of chronic epiphora or intermittent dacryocystitis. Local destruction and metastatic spread can be prevented by a high index of suspicion and early intervention.
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routine histopathologic evaluation of the Lacrimal Sac during dacryocystorhinostomy how useful is it
Ophthalmology, 2002Co-Authors: Robert C Kersten, Francesco P Bernardini, Mohammad Moin, Diana Reeves, Dwight R KulwinAbstract:Abstract Objective To determine the usefulness of "routine" Lacrimal Sac biopsy to evaluate unsuspected neoplasm or systemic disease in patients with acquired nasoLacrimal duct obstruction. Design Noncomparative, interventional case series with histopathologic correlation. Participants Review of charts revealed histopathologic reports on 302 specimens from 258 patients who had undergone routine dacryocystorhinostomy for clinical acquired nasoLacrimal duct obstruction. Intervention Dacryocystorhinostomy (DCR) with histopathologic evaluation of Lacrimal Sac. Main outcome measures The following variables were extracted from the medical records: age, gender, presenting symptoms, history of predisposing conditions, Lacrimal system abnormalities noted before surgery, dye disappearance test, dacryocystogram or dacryoscintillogram, appearance of the Lacrimal Sac during surgery, and histopathologic report of the Lacrimal Sac specimen. Results Findings of histopathologic evaluation of 302 Lacrimal Sac specimens from 170 females and 88 males who had undergone routine DCR were reviewed. Evidence of systemic disease or neoplasia involving the Lacrimal Sac was present in 10 specimens. All 10 positive specimens had a grossly abnormal appearing Sac at the time of surgery (n = 8), a known preexisting history of systemic diseases (n = 6), or both. The remaining 292 specimens showed chronic inflammation, fibrosis, or normal mucosa. Conclusions Only patients with known preexisting systemic disease or a grossly abnormal Lacrimal Sac had "positive" histopathologic findings. We recommend that Lacrimal Sac biopsy in patients undergoing DCR should be performed only in those with a positive history for systemic disease or an abnormal-appearing Lacrimal Sac during surgery.
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Routine histopathologic evaluation of the Lacrimal Sac during dacryocystorhinostomy: how useful is it?
Ophthalmology, 2002Co-Authors: Francesco P Bernardini, Robert C Kersten, Mohammad Moin, Diana Reeves, Dwight R KulwinAbstract:Abstract Objective To determine the usefulness of "routine" Lacrimal Sac biopsy to evaluate unsuspected neoplasm or systemic disease in patients with acquired nasoLacrimal duct obstruction. Design Noncomparative, interventional case series with histopathologic correlation. Participants Review of charts revealed histopathologic reports on 302 specimens from 258 patients who had undergone routine dacryocystorhinostomy for clinical acquired nasoLacrimal duct obstruction. Intervention Dacryocystorhinostomy (DCR) with histopathologic evaluation of Lacrimal Sac. Main outcome measures The following variables were extracted from the medical records: age, gender, presenting symptoms, history of predisposing conditions, Lacrimal system abnormalities noted before surgery, dye disappearance test, dacryocystogram or dacryoscintillogram, appearance of the Lacrimal Sac during surgery, and histopathologic report of the Lacrimal Sac specimen. Results Findings of histopathologic evaluation of 302 Lacrimal Sac specimens from 170 females and 88 males who had undergone routine DCR were reviewed. Evidence of systemic disease or neoplasia involving the Lacrimal Sac was present in 10 specimens. All 10 positive specimens had a grossly abnormal appearing Sac at the time of surgery (n = 8), a known preexisting history of systemic diseases (n = 6), or both. The remaining 292 specimens showed chronic inflammation, fibrosis, or normal mucosa. Conclusions Only patients with known preexisting systemic disease or a grossly abnormal Lacrimal Sac had "positive" histopathologic findings. We recommend that Lacrimal Sac biopsy in patients undergoing DCR should be performed only in those with a positive history for systemic disease or an abnormal-appearing Lacrimal Sac during surgery.
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management of congenital Lacrimal Sac fistula
Archives of Ophthalmology, 1990Co-Authors: Lee D Birchansky, Robert C Kersten, Jeffrey A Nerad, Dwight R KulwinAbstract:• Fourteen patients who were treated for symptomatic congenital Lacrimal Sac fistula were retrospectively reviewed to evaluate surgical success. Excision of the fistula alone was performed on 9 patients and excision with nasoLacrimal intubation on 5 patients (to our knowledge, the latter has not been previously described in the English literature). None of the 14 patients were symptomatic postoperatively during a mean follow-up of 16 months, with a range from 3 to 39 months. We conclude that dacryocystorhinostomy is usually not necessary to successfully treat symptomatic congenital Lacrimal Sac fistula.
Mary A Stefanyszyn - One of the best experts on this subject based on the ideXlab platform.
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glandular tumors of the Lacrimal Sac their histopathologic patterns and possible origins
Ophthalmology, 1996Co-Authors: Jacob Pe Er, Ahmed A Hidayat, Michael Ilsar, Louis Landau, Mary A StefanyszynAbstract:Purpose: To describe and characterize the primary Lacrimal Sac epithelial tumors of glandular origin, and to describe their possible source from glands in the Lacrimal Sac and nasoLacrimal duct walls. Methods: The authors conducted a clinicopathologic study on 14 patients with epithelial Lacrimal Sac tumors of possible glandular origin. In addition, they reviewed 35 surgical specimens of the Lacrimal Sac and nasoLacrimal duct region and 13 cadaver specimens of the Lacrimal Sac region. Results: Six of the tumors were benign: four were oncocytomas and two were pleomorphic adenomas. Eight of the tumors were malignant: three were oncocytic adenocarcinomas, three were adenoid cystic carcinomas, and two were adenocarcinomas. All tumors were from adults, ranging in age from 38 to 87 years. Twenty-eight of the 47 specimens of Lacrimal Sac and nasoLacrimal duct region showed mixed glands of serous and mucous elements. Conclusions: Although rare, benign and malignant glandular Lacrimal Sac tumors should be considered in the differential diagnosis of Lacrimal Sac obstruction. Their possible origin is from the normal glands that exist under the Lacrimal Sac and nasoLacrimal duct epithelium.
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nonepithelial tumors of the Lacrimal Sac
American Journal of Ophthalmology, 1994Co-Authors: Jacob Peer, Mary A Stefanyszyn, Ahmed A HidayatAbstract:Lacrimal Sac tumors are rare and mostly of epithelial origin. We conducted a clinicopathologic study of 35 cases of nonepithelial tumors of the Lacrimal Sac. These tumors included 13 fibrous histiocytomas, one hemangiopericytoma, one lipoma, ten lymphoid lesions, eight malignant melanomas, one granulocytic sarcoma, and one neurofibroma. Except for one 9-year-old child with fibrous histiocytoma, all neoplasms involved adults (age range, 27 to 90 years). The most common initial signs and symptoms were epiphora, chronic inflammation, or Lacrimal mass. A bloody nasal discharge and bleeding from the punctum occurred in a patient with malignant melanoma. In none of the patients was the clinical diagnosis of a Lacrimal Sac tumor made preoperatively. Some of the nonepithelial neoplasms of the Lacrimal Sac can be life-threatening; therefore, early diagnosis and treatment are important.
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Lacrimal Sac tumors
Ophthalmic Plastic and Reconstructive Surgery, 1994Co-Authors: Mary A Stefanyszyn, Ahmed A Hidayat, Jacob Peer, Joseph C. FlanaganAbstract:Tumors of the Lacrimal drainage system, especially the Lacrimal Sac, are rare. Despite their rarity, physicians should be aware of the clinical features of Lacrimal Sac tumors, as many are life-threatening and early diagnosis and appropriate treatment can save lives. These tumors often masquerade as a chronic inflammatory process. Due to the rarity of Lacrimal Sac tumors, large clinical studies with statistically meaningful data are unavailable, and we learn about the biological behavior, management, and prognosis of these tumors only from case series and case reports. Lacrimal Sac tumors are usually diagnosed in adults and more than half of them are malignant. About three-quarters of these tumors are of epithelial origin. The main sign of these tumors is a mass in the Lacrimal Sac area. Although most of the tumors present with symptoms of Lacrimal drainage obstructions, many of them are found inadvertently at the time of dacryocystorhinostomy (DCR). Therefore, it has been suggested by some authors that a Lacrimal Sac biopsy during a DCR should always be submitted for pathological evaluation. Other surgeons use criteria discussed in this chapter to obtain histopathology in specific cases. Imaging techniques such as CT scan, MRI, ultrasound, and dacryocystography may help in the diagnosis. Complete surgical removal by various techniques is the gold standard in treating Lacrimal Sac tumors, accompanied in malignant cases by radiation therapy and chemotherapy and, when needed, followed by reconstruction. Recurrence and mortality rate vary according to the type of the tumor and its extent.
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Lacrimal Sac Tumors and Inflammations
Management of Orbital and Ocular Adnexal Tumors and Inflammations, 1990Co-Authors: Joseph C. Flanagan, Joseph A. Mauriello, Mary A StefanyszynAbstract:As with other tumors and inflammations of the ocular adnexae, diagnosing Lacrimal Sac tumors first requires determining whether the patient has an underlying inflammation or a tumor.
Lee D Birchansky - One of the best experts on this subject based on the ideXlab platform.
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management of congenital Lacrimal Sac fistula
Archives of Ophthalmology, 1990Co-Authors: Lee D Birchansky, Robert C Kersten, Jeffrey A Nerad, Dwight R KulwinAbstract:• Fourteen patients who were treated for symptomatic congenital Lacrimal Sac fistula were retrospectively reviewed to evaluate surgical success. Excision of the fistula alone was performed on 9 patients and excision with nasoLacrimal intubation on 5 patients (to our knowledge, the latter has not been previously described in the English literature). None of the 14 patients were symptomatic postoperatively during a mean follow-up of 16 months, with a range from 3 to 39 months. We conclude that dacryocystorhinostomy is usually not necessary to successfully treat symptomatic congenital Lacrimal Sac fistula.
Sibel Aker - One of the best experts on this subject based on the ideXlab platform.
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pyogenic granuloma of the Lacrimal Sac
International Ophthalmology, 2009Co-Authors: Bulent Yazici, Ayse Tor Ayvaz, Sibel AkerAbstract:In this report, we describe three adult patients diagnosed with Lacrimal Sac pyogenic granuloma. The presenting symptoms were acute dacryocystitis, Lacrimal mass, and bloody tears. The nasoLacrimal drainage pathway was obstructed in all cases. Radiologic evaluation performed in one patient revealed the presence of a well-defined mass in the Sac with homogenous contrast uptake. Histopathologic examination revealed capillary proliferation and inflammatory cells in a fibromyxoid stroma. The patients were followed up for 11–23 months after external dacryocystorhinostomy without recurrence of the tumor or nasoLacrimal obstruction. Pyogenic granuloma may develop from the Lacrimal Sac mucosa and may cause bloody epiphora. Such a tumor is visualized as a hemorrhagic mass lesion, and it may not have a negative effect on the outcome of DCR.
