No abstract

Rationale:Immunoglobulin G4-related disease (IgG4-RD) is an inflammatory condition of unknown cause. Cancer might be related to the development of certain IgG4-RD but to date, little literature documents it.Patient concerns:A 78-year old man presented with unilateral proptosis responsive to steroids, initially attributed to nonspecific orbital inflammation.Diagnosis:Right hemicolectomy was performed because of a suspicious lesion which turned out to be tubulovillous adenoma on histological analysis. Eight months after the surgery, a mass infiltrating the mesentery was found and biopsy revealed IgG4-RD.Interventions:Both the orbital inflammation and abdominal mass infiltrating the mesentery were responsive to steroids and rituximab administered to treat IgG4-RD.Outcomes:In the course of IgG4-RD, the patient developed bilateral optic perineuritis, causing bilateral visual loss. Colon cancer with synchronous multiple liver metastases was found 1 year after rituximab treatment.Lessons:This case raises the possibility of IgG4-RD being a paraneoplastic syndrome in some patients. Cancer screening should probably be performed in some elderly patients diagnosed with IgG4-RD.

A 51-year old female presented with upper lid retraction after glaucoma filtering surgery. After two surgical procedures to correct the retraction with only transient effect, she was finally treated with hyaluronic acid gel filling achieving good aesthetic and functional result.

Few cases of ophthalmic complications have been reported following sinus endoscopic surgery with current techniques. Irreversible damage to orbital structures was found in a 21-year-old patient referred to our department for evaluation after sinus endoscopic surgery and ipsilateral amaurosis.

This algorithm quantifies conjunctival-Müellerectomy during blepharoptosis repair. Excellent and very predictable results are obtained by a technique that is both simple and achievable in a short operating time.