| Identifier |
walsh_2015_s3_c3 |
| Title |
The Man with No Face (About Face) |
| Creator |
Michael Vaphiades; Jennifer Doyle; Lina Nagia; Kevin Bray; Kline Lanning; Glenn Roberson; Adam Quinn; Joel Cure; Katherine Fening |
| Affiliation |
(MV) (JD) (LN) (KB) (KL) (AQ) University of Alabama/Ophthalmology Birmingham, AL; (GR) (JC) University of Alabama/Radiology Birmingham, AL; (KF) University of Alabama/Dermatology Birmingham, AL |
| Subject |
Basal Cell, Visual Loss, Destructive Process, Head and Neck, Carcinoma |
| History |
A 61-year-old man presented with one week history of decreased vision OS. Past medical history includes asthma and amblyopia OD, but with complete visual loss OD 18 years prior. He takes no medications. He is retired but worked for 21 years in social science research. The remarkable thing upon meeting this articulate intelligent individual is he had no face. On exam his visual acuity was NLP OD and HM OS. There was no view of the pupil OD and a poor view OS but there is minimal reactivity. Color vision was non-recordable. Confrontational visual field showed marked constriction OS. Extraocular muscle exam showed complete restriction OD and a small amount of movement in all cardinal directions OS. External exam OD revealed absence of eyelids, exposed globe, and dense corneal scar with no view into the anterior chamber. External exam OS showed thick, keratinized upper and lower lids temporally and absence of lids medially, and 360 degrees of conjunctival chemosis, diffuse corneal edema with white lesion inferonasally, and a formed AC with poor view. Intraocular pressure was non-measurable OD and 40 mm Hg OS. No view of the fundus OU. Cranial and orbital CT and MRI revealed extensive destruction of soft tissue of the face that abuts and likely invades the dura. The right globe was involved, the left globe appeared intact. The intracranial and prechiasmatic portion of the optic nerves appeared normal. There was no definite evidence of involvement of the cavernous sinuses. However, there was disease surrounding several intracranial nerve roots, which likely represents perineural invasion of these structures. A biopsy was obtained. |
| Disease/Diagnosis |
Invasive basal cell carcinoma of the face |
| Date |
2015-02 |
| References |
1. Ghanadan A, et al. Different Anatomical Distribution of Basal Cell Carcinoma Subtypes in Iranian Population: Association between Site and Subtype. Ann Dermatol. 2014 ;26:559-63. 2. Menesi W, et al. A reliable frozen section technique for basal cell carcinomas of the head and neck. Can J Plast Surg. 2014;22:179-82. 3. Slutsky JB, Jones EC. Periocular cutaneous malignancies: a review of the literature. Dermatol Surg. 2012;38:552-69. 4. Tan E, et al. Growth of Periocular Basal Cell Carcinoma. Br J Dermatol. 2014 [Epub ahead of print]. |
| Language |
eng |
| Format |
application/pdf |
| Type |
Text |
| Relation is Part of |
NANOS Annual Meeting Frank B. Walsh Sessions; 2015 |
| Collection |
Neuro-Ophthalmology Virtual Education Library: Walsh Session Annual Meeting Archives: https://novel.utah.edu/Walsh/ |
| Publisher |
North American Neuro-Ophthalmology Society |
| Holding Institution |
Spencer S. Eccles Health Sciences Library, University of Utah |
| Rights Management |
Copyright 2015. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
| ARK |
ark:/87278/s6739nhq |
| Setname |
ehsl_novel_fbw |
| ID |
179250 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6739nhq |
