Öz
Orbital metastasis in solid tumors, especially in colon adenocarcinomas, is very rare and its management is a real challenge in clinical oncology. Here, we report a 60-year-old woman with stage IV colon adenocarcinoma, who was admitted with ophthalmic complaints while under systemic chemotherapy. The patient had conjunctival chemosis, severe exophthalmos,
ptosis, and limitation of movement on the left eye. Magnetic resonance imaging revealed a 35x21 mm soft tissue mass in the left orbita. The patient refused further treatment and was released in 15 days. The treatment of metastatic orbital tumors is often multidisciplinary; combining local treatments (surgery and radiotherapy), systemic treatments (chemotherapy, biological and hormonal therapies), and palliative approaches (mainly based on corticosteroids) together. The disease has poor prognosis due to dissemination of the systemic cancer.
Anahtar Kelimeler
Kaynakça
- Amemiya T, Hayashida H, Dake Y. Metastatic orbital tumors in Japan: a
- review of the literature. Ophthalmic Epidemiol. 2002;9 (1) :35-47.
- Valenzuela AA, Archibald CW, Fleming B, Ong L, O'Donnell B, Crompton
- J J, et al. Orbital metastasis: clinical features, management and outcome.
- Orbit. 2009;28 (2-3) :153-9.
- Ferry A, Font R. Carcinoma metastatic to the eye and orbit: a
- clinicopathological study of 227 cases. Arch Ophthalmol. 1974 Oct;92 (4)
- :276-86.
- García-Fernández M, Castro-Navarro J, Saiz-Ayala A, Álvarez-Fernández
- C. Orbital metastases in colorectal cancer: a case report. Arch Soc Esp
- Oftalmol. 2012;87 (7) :216-9.
- Tunc M. Current Diagnostic and Management Methods in Orbital Tumors.
- Turk J Ophthalmol 2014;44 (Özel Sayı) : 1-7
- S. B. Rudoler MD, C. L. Shields MD, J. A. Shields MD. Radiation Therapy
- of Uveal and Orbital Metastases. Radiotherapy of Intraocular and Orbital
- Tumors Medical Radiology 2003, pp 87-93.
- Demirci H, Shields CL, Chao AN, Shields JA. Uveal metastasis from breast
- cancer in 264 patients. Am J Ophthalmol. 2003;136 (2) :264-71.
- Koma Y, Goto K, Yoshida C, Kimura K, Matsumoto Y, Koyama M, et al.
- Orbital metastasis secondary to pulmonary adenocarcinoma treated with
- gefitinib: a case report. J Med Case Rep. 2012;18 (6) :353.
- Saitoh A., Amemia T., Tsuda N. Metatases of breast carcinoma to eyelid and
- orbid of a postmenapausal women; good respons to tamoxifen therapy.
- Ophthalmologica. 1997;211 (6) :362-6.
- El Mejjad A, Jouhadi H, Fekak H, Rabii R, Bennani S, Benider A, et al. Orbital
- metastasis of prostatic carcinoma. Prog Urol. 2005;15 (1) :85-8.
- Papageorgiou KI, Sinha A, Ioannidis AS, Davidson NG. Ocular metastases
- from HER2 positive breast carcinoma and the response to combination
- therapy with Paclitaxel and Trastuzumab: A case report. Cases J. 2009;4
- (2) :9143.
- Wong ZW, Phillips SJ, Ellis MJ. Dramatic response of choroidal metastases
- from breast cancer to a combination of trastuzumab and vinorelbine. Breast
- J. 2004 ;10 (1) :54-6.
- Ju UH, Tsai ML, Lin CS, Chao TY, Dai MS. Lapatinib and platinum-based
- chemotherapy ameliorate breast cancer with choroidal metastasis and
- restore visual acuity. Tumori. 2014;100 (3) :e67-9.
- Ngo E, Hutchins LF, Gardner JM, Uwaydat SH. Regression of orbital and
- choroidal metastases from melanoma after treatment with vemurafenib.
- Can J Ophthalmol. 2014;49 (2) :e49-52.
- Yin VT, Pfeiffer ML, Esmaeli B. Targeted Therapy for Orbital and Periocular
- Basal Cell Carcinoma and Squamous Cell Carcinoma. Ophthal Plast Reconstr Surg. 2013;29 (2) :87-92.
Öz
Orbital metastaz tüm solid tümörlerde, özellikle de kolon adenokarsinomunda oldukça nadir bir durumdur ve yönetimi klinik onkolojide gerçek bir sorundur. Biz bu yazıda 60 yaşında, evre IV kolon adenokarsinomu tanısı olan ve sistemik kemoterapi altında oftalmik şikayetler ile başvuran kadın hastayı bildiriyoruz. Hastanın sol gözünde konjonktival kemozis,
şiddetli egzoftalmi, pitozis ve hareket kısıtlılığı vardı. Manyetik rezonans görüntüleme sol orbita bir 35x21 mm’lik yumuşak doku kitlesi saptandı. Sunulan olgu ileri tedaviyi reddetti ve 15 gün içinde eksitus oldu. Orbital metastatik tümörlerin tedavisi; lokal tedaviler (cerrahi ve radyoterapi), sistemik tedaviler (kemoterapi, biyolojik ve hormonal tedaviler) ve palyatif yöntemlerin (kortikosteroid temelli tedaviler) birlikte katılımı ile multidisipliner olarak yapılmalıdır ancak hastalığın yaygın
hale gelmiş olması sebebiyle hastalık kötü prognozludur.
Kaynakça
- Amemiya T, Hayashida H, Dake Y. Metastatic orbital tumors in Japan: a
- review of the literature. Ophthalmic Epidemiol. 2002;9 (1) :35-47.
- Valenzuela AA, Archibald CW, Fleming B, Ong L, O'Donnell B, Crompton
- J J, et al. Orbital metastasis: clinical features, management and outcome.
- Orbit. 2009;28 (2-3) :153-9.
- Ferry A, Font R. Carcinoma metastatic to the eye and orbit: a
- clinicopathological study of 227 cases. Arch Ophthalmol. 1974 Oct;92 (4)
- :276-86.
- García-Fernández M, Castro-Navarro J, Saiz-Ayala A, Álvarez-Fernández
- C. Orbital metastases in colorectal cancer: a case report. Arch Soc Esp
- Oftalmol. 2012;87 (7) :216-9.
- Tunc M. Current Diagnostic and Management Methods in Orbital Tumors.
- Turk J Ophthalmol 2014;44 (Özel Sayı) : 1-7
- S. B. Rudoler MD, C. L. Shields MD, J. A. Shields MD. Radiation Therapy
- of Uveal and Orbital Metastases. Radiotherapy of Intraocular and Orbital
- Tumors Medical Radiology 2003, pp 87-93.
- Demirci H, Shields CL, Chao AN, Shields JA. Uveal metastasis from breast
- cancer in 264 patients. Am J Ophthalmol. 2003;136 (2) :264-71.
- Koma Y, Goto K, Yoshida C, Kimura K, Matsumoto Y, Koyama M, et al.
- Orbital metastasis secondary to pulmonary adenocarcinoma treated with
- gefitinib: a case report. J Med Case Rep. 2012;18 (6) :353.
- Saitoh A., Amemia T., Tsuda N. Metatases of breast carcinoma to eyelid and
- orbid of a postmenapausal women; good respons to tamoxifen therapy.
- Ophthalmologica. 1997;211 (6) :362-6.
- El Mejjad A, Jouhadi H, Fekak H, Rabii R, Bennani S, Benider A, et al. Orbital
- metastasis of prostatic carcinoma. Prog Urol. 2005;15 (1) :85-8.
- Papageorgiou KI, Sinha A, Ioannidis AS, Davidson NG. Ocular metastases
- from HER2 positive breast carcinoma and the response to combination
- therapy with Paclitaxel and Trastuzumab: A case report. Cases J. 2009;4
- (2) :9143.
- Wong ZW, Phillips SJ, Ellis MJ. Dramatic response of choroidal metastases
- from breast cancer to a combination of trastuzumab and vinorelbine. Breast
- J. 2004 ;10 (1) :54-6.
- Ju UH, Tsai ML, Lin CS, Chao TY, Dai MS. Lapatinib and platinum-based
- chemotherapy ameliorate breast cancer with choroidal metastasis and
- restore visual acuity. Tumori. 2014;100 (3) :e67-9.
- Ngo E, Hutchins LF, Gardner JM, Uwaydat SH. Regression of orbital and
- choroidal metastases from melanoma after treatment with vemurafenib.
- Can J Ophthalmol. 2014;49 (2) :e49-52.
- Yin VT, Pfeiffer ML, Esmaeli B. Targeted Therapy for Orbital and Periocular
- Basal Cell Carcinoma and Squamous Cell Carcinoma. Ophthal Plast Reconstr Surg. 2013;29 (2) :87-92.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 18 Aralık 2015 |
| Gönderilme Tarihi | 18 Aralık 2015 |
| Yayımlandığı Sayı | Yıl 2015 Cilt: 1 Sayı: 3 |