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All Journal Majalah Kedokteran Bandung JKKI : Jurnal Kedokteran dan Kesehatan Indonesia
Dewi, Niluh Putu Ayu
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Medicine & Pharmacology Public Health

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The diagnostic challenge of orbital tuberculosis in an otherwise healthy individual: A case report Kartiwa, Raden Angga; Elsyanty, Firda Muthia; Setiawan, Grace; Dewi, Niluh Putu Ayu; Boesoirie, Shanti Fitrianti; Dahlan, Mohammad Rinaldi
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 15, No 3, (2024)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol15.Iss3.art15

Abstract

Ocular tuberculosis occurs in 1.5-18% of all extrapulmonary tuberculosis cases, with orbital tuberculosis being a very small proportion of all cases of ocular tuberculosis. High variability of manifestations of orbital tuberculosis may result in delayed diagnosis. Children are the populations most affected by this disease. This study aims to report a case of orbital tuberculosis in a patient without systemic tuberculosis symptoms. We presents a 13-year-old girl who is reported protrusion of the right eye for four months. She complained diplopia and pain in the right eye radiating to the head. She reported no other systemic symptoms. Ophthalmological examination revealed that her best corrected visual acuity of the right eye was 0.25, and the left eye was 1.0. The movement of the right eye was limited to the superior, temporal, and nasal directions. Anterior segment examinations demonstrated proptosis of the right eye with 3 mm of lagophthalmos. The patient then underwent an orbitotomy and biopsy procedure. Histopathological analysis revealed chronic granulomatous inflammation with Langerhans cells, indicative of tuberculosis. The patient was diagnosed with proptosis of the right eye and multiple cranial nerve palsy due to orbital tuberculosis. The patient was subsequently prescribed an antituberculosis treatment and attended regular monthly follow-ups. Ten months after surgery and completed antituberculosis treatment, the proptosis improves and there is no further growth of the mass. Orbital tuberculosis is a rare condition and is often challenging to diagnose, particularly in healthy individuals. Thorough history taking, physical examination, and ancillary testing are essential to establish an accurate diagnosis. This case emphasizes the necessity for heightened suspicion of tuberculosis in atypical presentations, particularly in pediatric patients in endemic areas, to prevent morbidity and ensure timely treatment.
Rare Eccrine Porocarcinoma of The Eyelid in A Non-Caucasian Patient Boesoirie, Shanti F.; Mardianty, Friska; Wahyu, Tri; Dewi, Niluh Putu Ayu; Nursalamah, Mia; Dahlan, Mohamad Rinaldi; Kartiwa, Raden Angga
Majalah Kedokteran Bandung Vol 57, No 4 (2025)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v57.4193

Abstract

Eccrine porocarcinoma of the eyelid is a rare and locally aggressive tumor with a significant risk of metastasis and recurrence after surgical excision. There are only eight cases of eyelid porocarcinoma reported in the literature, most involve Caucasian patients. A 58-year-old non-Caucasian male had a recurrent mass of the left upper eyelid for a year. He underwent two prior mass removal procedures in the same location of the upper eyelid. At the time of this study, the patient underwent full-thickness excision, and a lateral canthal defect with superior palpebral involvement was sacrificed. The periosteal flap from the lateral orbital rim was attached to the edge of the intact tarsal plate of the upper eyelid as a part of the defect reconstruction. Good outcomes in terms of tumor recurrences, cosmesis, and upper eyelid functionality were observed one month following surgery. According to the histopathology, the tumor was identified as eccrine porocarcinoma, and the patient was recommended for chemotherapy. The 4-month follow-up showed no recurrence or metastasis. Eccrine porocarcinoma is a rare condition that should be taken into account when making a differential diagnosis for patient with malignant eyelid tumors. Wide excision is still a treatment of choice. 
Co-Authors Boesoirie, Shanti F. Boesoirie, Shanti Fitrianti Dahlan, Mohamad Rinaldi Dahlan, Mohammad Rinaldi Elsyanty, Firda Muthia Kartiwa, Raden Angga Mardianty, Friska Nursalamah, Mia Setiawan, Grace Tri Wahyu