Presentation
To describe a rare orbital metastasis with atypical presentation. Retrospective case report. [ncbi.nlm.nih.gov]
Entire Body System
- Pain
Abstract A 63-year old male with chronic shoulder pain and painful left eye with binocular diplopia of sudden onset was seen independently by Ophthalmologists and his family Doctor and investigated first non-invasively where masses were found both in [ncbi.nlm.nih.gov]
- Falling
Alle Patienten wurden einer chirurgischen Behandlung unterzogen (Exenteratio in 5 Fällen; subtotale Exenteratio orbitae in einem Fall; subtotale Exzision in zwei Fällen und kraniofaziale Resektion in einem Fall) kombiniert mit Immuntherapie in einem Fall [thieme-connect.com]
Sarcoma of the orbit staging: T stage: the main tumor mass (sarcoma of the orbit) Based on a physical examination and review of any imaging, your doctor should be able to give you a T stage that falls within one of the following categories. [headandneckcancerguide.org]
[…] definition is Stage 4 disease according to the International Neuroblastoma Staging System.6 Treatment of the primary disease is based on Children's Oncology Group Neuroblastoma Risk Group Assignment Schema of low, intermediate, or high.7 Orbital involvement falls [nature.com]
- Surgical Procedure
Total or near-total thyroidectomy is considered a proper surgical procedure for HCTC. Generally, after an inadequate surgical procedure a completion thyroidectomy is performed. [bmccancer.biomedcentral.com]
Clinical suspicion, repeated endoscopic procedures, and intimate histologic analysis including immunohistochemistry is necessary for appropriate diagnosis, which might help to avoid unnecessary surgical procedure owing to incorrect diagnosis. [omicsonline.org]
Cardiovascular
- Hypertension
His mother and maternal grandfather died from complications of hypertension. [jmedtropics.org]
Since neuroblastoma has the propensity for increased catecholamine production, symptoms may include flushing, hypertension, diaphoresis, tachycardia, intractable diarrhea, and hyperglycemia. [appliedradiology.com]
[…] pathophysiological pathway in Kounis syndrome and non allergic acute coronary syndrome Domina Petric Int J Med Rev Case Rep. 2022; 6(14): 14-15 » Abstract » PDF» doi: 10.5455/IJMRCR.172-1644937731 Case Report Death due to Pulmonary Embolism and Pulmonary Hypertension [mdpub.net]
Causes include blunt head trauma (80% of cases), post-surgery (eg, septorhinoplasty), carotid aneurysm rupture with reflux of blood into the cavernous sinus or it can occur spontaneously (especially in hypertensive patients). [patient.info]
Skin
- Erythema
The side effects of the treatment included tenderness, acute erythema, and skin desquamation at the end of treatment, which required antimicrobial therapy due to concern for cellulitis. There was no change in visual acuity. [cureus.com]
Confrontation visual fields: Full OU Motility: OD: Moderately limited in all directions, especially right gaze OS: Full External exam (Figure 1 and 2): OD: Enophthalmos, ptosis, mild periorbital edema/erythema. [webeye.ophth.uiowa.edu]
Eyelid and conjunctival RMS often present as a gradually enlarging, well circumscribed mass, that may have associated eyelid edema and erythema as well as chemosis. [eyewiki.aao.org]
Eyes
- Diplopia
This case showed that retro-orbital metastasis should be considered as a differential diagnosis in a patient with thyroid cancer who presents with unilateral diplopia. [ncbi.nlm.nih.gov]
Without 131 I therapy, diplopia occurred from metastasis to the right medial rectus muscle. Improvement followed after one therapy dose of 131 I. [karger.com]
A 66-year-old man presented with a 3-week history of right eye pain and diplopia. He also reported a 4- to 5-month history of urinary frequency, hematuria, and passing gray-white particles in his urine. [archivesofpathology.org]
- Strabismus
The most common presenting signs and symptoms included diplopia with noncomitant strabismus, proptosis, and a palpable mass. In nine cases (26%), the orbital metastasis was detected in patients with no prior history of cancer. [ncbi.nlm.nih.gov]
Paraneoplastic neurologic findings including cerebellar ataxia or opsoclonus/myoclonus (dancing eyes, dancing feet) may occur.5 Other manifestations include Horner's syndrome, aniscoria, and strabismus.2 Ophthalmic involvement by definition is Stage 4 [nature.com]
J Pediatr Ophthalmol Strabismus 2007;44:106-11. [ PUBMED ] 2. Volpe NJ, Jakobiec FA. Pediatric Orbital tumors. Int Ophthalmol Clin 1992;32:201-21. [ PUBMED ] 3. Shields JA, Shields CL. Rhabdomyosarcoma: review for the ophthalmologist. [ojoonline.org]
- Blurred Vision
A 70 year-old female presented with a gradually worsening blurred vision, periorbital swelling and ascites. [ncbi.nlm.nih.gov]
Ocular Medical History: since 4 weeks proptosis, limited ocular motility, and blurred vision. General Medical History: history of previous breast cancer. Main Complaint: proptosis. Purpose: to present severe proptosis in mamma carcinoma. [atlasophthalmology.net]
Six years later, he presented with blurring of vision and was found to have a well-defined mass involving levator palpebre and superior rectus muscles. [endocrine-abstracts.org]
- Unilateral Proptosis
A 44-year-old man presented with unilateral proptosis and progressively deteriorating vision of his left eye over a 2-week period. [ncbi.nlm.nih.gov]
Unilateral proptosis as a manifestation of orbital metastasis from follicular thyroid cancer is rarely reported. [medcraveonline.com]
Basu S, Nair N, Aravind N: Unilateral proptosis with thyrotoxicosis resulting from solitary retroorbital soft tissue metastasis from follicular carcinoma thyroid. Clin Nucl Med 2001;26:136–138. Henderson JW: Orbital Tumors, ed 3. [karger.com]
- Eye Pain
On initial presentation, her eye pain and mass was attributed to ocular sarcoidosis. [ascopubs.org]
A 66-year-old man presented with a 3-week history of right eye pain and diplopia. He also reported a 4- to 5-month history of urinary frequency, hematuria, and passing gray-white particles in his urine. [archivesofpathology.org]
Pain is an uncommon symptom of a lymphoproliferative lesion, in contrast to orbital pseudotumor, which manifests with acute pain ( 14 ). [pubs.rsna.org]
Workup
It is recommended that any patient with visual symptoms and known urothelial cancer should undergo expedited workup for metastatic disease. [urotoday.com]
Workup revealed type Ⅲ advanced gastric cancer at the lesser curvature of the gastric antrum. Biopsy revealed a diagnosis of poorly differentiated adenocarcinoma. [dear-medic.jp]
The workup of suspected metastatic scirrhous breast cancer to the orbit includes a complete history and physical, imaging of the orbit (CT or MRI), mammogram, orbital mass biopsy and body imaging for metastatic disease. [webeye.ophth.uiowa.edu]
A diagnosis of a giant basal cell carcinoma metastatic to the lungs was established;the patient had an ECOG performance status of 2, a blood workup showed he had normal renal function. Platinum based chemotherapy was decided. [panafrican-med-journal.com]
Diagnosis, Workup and Treatment Laboratory blood work was sent, including TSH, T3, free T4 and thyroid stimulating immunoglobulin, which all came back within normal limits. The patient underwent further imaging to characterize the orbit pathology. [reviewofophthalmology.com]
Treatment
Radiotherapy remains an efficacious modality for treatment of orbital metastases. [ncbi.nlm.nih.gov]
The complications of treatment were sensorineural hearing loss and developmental delay in one child and optic atrophy due to orbital cellulitis in another. Two of the children had completed all treatment and were under observational follow-up. [nature.com]
The patient is continuing gefitinib treatment without any adverse effects noted on computed tomography, physical, or laboratory examination. [jmedicalcasereports.biomedcentral.com]
treatment on axial (C) and coronal images (D). [wjgnet.com]
Prognosis
Orbital metastasis of urinary bladder carcinoma is associated with a poor prognosis and is more frequently observed in older people. In addition, it is five times more prevalent in men than in women. [ncbi.nlm.nih.gov]
T1: isointense to muscle 8 T2: hyperintense to muscle, hypointense to fat T1 C+ (Gd): enhancement present but variable Treatment and prognosis Treatment is primarily with radiotherapy, typically with a total dose of 30-40 Gy 1. [radiopaedia.org]
Etiology
Systemic history and orbital imaging play an important role in differentiating the infective etiology from metastasis. [sjopthal.net]
[…] between the ages of 15 and 35 years, with a slightly higher incidence in women. 3 Although multiple predisposing factors have been identified such as genetic diseases, radiation exposure, certain chemical agents, lymphedema, and trauma, no specific etiology [mdmag.com]
MacFaul stated in his “System of ophthalmology” that unlike exophthalmos, enophthalmos could not lead to a fatal outcome [ 7 ]; because his classification failed to mention orbital tumors as a possible etiology. [bmcpediatr.biomedcentral.com]
Disease Orbital Cellulitis (ICD-9 #376.01) Etiology Orbital cellulitis most commonly occurs when bacterial infection spreads from the paranasal sinuses, most often from the ethmoid sinus through the thin lamina papyracea of the medial orbital wall. [eyewiki.aao.org]
The etiology of breast cancer metastasis to the head and neck region is largely unknown. [journals.lww.com]
Epidemiology
American journal of epidemiology, 155(4): 323-31 [ CR ] [ PM ] [ EČ ][ GS ] Fan, Z., Rijn, M., Montgomery, K., Rouse, R.V. (2003) Hep par 1 antibody stain for the differential diagnosis of hepatocellular carcinoma: 676 tumors tested using tissue microarrays [scindeks.ceon.rs]
Prostate cancer epidemiology. Lancet 2003;361:859-64. [Figure 1], [Figure 2], [Figure 3] This article has been cited by 1 Unilateral exophthalmos revealing metastatic prostate cancer El Yazami Adli, O., Elammari, J.E., Elfassi, M.J., Farih, M.H. [indianjcancer.com]
Diagnosis: Enophthalmos Secondary to Metastatic Scirrhous Breast Cancer to the Orbit Epidemiology Less than 20% of patients with enophthalmos (Cline) 76% of enophthalmos due to metastasis Signs Enophthalmos Impaired motility Ptosis Impaired levator function [webeye.ophth.uiowa.edu]
INTRODUCTION According to Surveillance, Epidemiology, and End Results data, the incidence of hepatocellular carcinoma (HCC) has been steadily increasing since the mid-1980s and thus presents an increasing health problem in the United States. [wjgnet.com]
Pathophysiology
The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders. Psychoneuroendocrinology, 25(1), 1-35. Pagina 52 - In: Wall PD, Melzack R (eds), Textbook of pain. Churchill Livingstone, Edinburgh... [books.google.it]
Sleisenger and Fordtran’s gastrointestinal and liver disease: pathophysiology, diagnosis, management. 9th Ed. Philadelphia (PA): Saunders/Elsevier; 2010. 2. Kong BD, Lee TW. Clinical analysis of metastatic intraocular malignancy. [e-ce.org]
Mahmutovic, Alma Mizdrak, Amina Luckin, Zineta Mulaosmanovic, Amela Salihovic, Almedina Alihodzic Int J Med Rev Case Rep. 2022; 6(14): 5-13 » Abstract » PDF» doi: 10.5455/IJMRCR.172-1638393956 Letter to the Editor Potential clinical relevance of the common pathophysiological [mdpub.net]
Types of invasive breast carcinoma include ductal, lobular, and mixed. [5] Pathophysiology To date, the basis for breast carcinoma as the most common primary metastatic process to the orbit is unclear. [eyewiki.aao.org]
Prevention
The clear margins may prevent local recurrence, but they do not prevent micro-metastasis to lymph nodes or distant organs via the blood stream. [ojoonline.org]
Prevention of bone loss with alendronate in postmenopausal women under 60 years of age. Pagina 74 - Heim, C".., Ehlert, U., & Hellhammer, DH (2000). The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders. [books.google.it]
The remaining two patients were capable of being diagnosed early, and immediate radiotherapy for their tumors provided dramatic symptomatic remission and long-term prevention of recurrence of symptoms. [ci.nii.ac.jp]
Primary prevention Identifying patients and effectively treating upper respiratory or sinus infections before they evolve into orbital cellulitis is an important aspect of preventing preseptal cellulitis from progressing to orbital cellulitis. [eyewiki.aao.org]
[…] a case of giant basal cell carcinoma metastaticin lung occurringin a 79 years old male patient, with a fatal evolution after one course of systemic chemotherapy.Giant basal cell carcinoma is a very rare entity, early detection of these tumors could prevent [panafrican-med-journal.com]