Introduction: Tuberculosis is a transmissible infectious disease caused by mycobacterium tuberculosis. Ocular tuberculosis is rare representing between 1% to 18% of all forms of tuberculosis and only 0.3% of patients develop the orbital form. The focus is usually unilateral, we report through this observation a case of bilateral orbital tuberculosis in a 12 year old girl. Observation: A 12-year-old girl was admitted to the department of infectious and tropical diseases of the National Hospital of Zinder for long term fever and violent headache. The ophthalmological examination revealed a visual acuity of 1/10 on the right, absence of light perception on the left and bilateral exophthalmos. Biomicroscopic examination showed superficial punctate keratitis bilaterally, a normal fundus on the right and left atrophy. In view of the long-lasting fever and the biological inflammatory syndrome, the diagnosis of tuberculosis was evoked. The tuberculin intradermal test (IDR) was positive and the search for BK in the bronchial lavage revealed BAARs. HIV serology was negative. The standard chest X-ray was normal but the CT scan of the orbito- cerebral cavity showed two cystic foci with grade III exophthalmos. After 3 months of anticillary treatment the evolution was considered satisfactory. Conclusion: The orbital involvement of tuberculosis was generally unilateral, its bilateral localization is unusual. It must be systematically evoked in front of any case of bilateral exophthalmos especially in an infectious context in order to avoid irrevesible vsion loss.
Purpose: The aim of this study was to describe the management of a case of malignant melanoma of the conjunctiva at the National Hospital of Zinder in Niger and review of the literature. Observation: This was a young adult, 46 years old, male, from Agadez, with an unfavorable socioeconomic status, with no particular history referred for an upper left eyelid tumour. On examination, his general condition was preserved. On inspection, a mass hanging from the free edge of the left upper eyelid was noted; resulting in total mechanical ptosis preventing examination of the condition was preserved. On inspection, a mass hanging from the free edge of the left upper eyelid was noted, resulting in total mechanical ptosis preventing examination of the anterior segment. Palpation of the orbital rim did not note anything in particular, the lymph node areas were free. On the ophthalmological examination, on the right the visual acuity from afar without correction was 10/10 with a normal biomicroscopic examination, on the left the visual acuity was counting the fingers at one meter and a biomicroscopy hampered by the ptosis The assessment laboratory was normal, the orbitocerebral computed tomography showed the conjunctival origin of the tumor without notion of extension in the vicinity. Macroscopically complete excision was performed. Histopathological examination of the approximately 5 cm surgical specimen noted a malignant melanoma of the conjunctiva with impregnation of the margins (R1 resection). Adjuvant treatment with mitomycin C was instituted. The postoperative course was simple. After 6 months of postoperative follow-up, the ophthalmological examination was normal and the search for metastases was negative. Conclusion: Malignant melanoma of the conjunctiva is a rare neoplasia that can mimic a palpebral tumor. Histopathological examination remains important for treatment and monitoring.
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