Massive Orbital Metastasis of Hepatocellular Carcinoma.

Abstract

Compared to other organs, the eyes are relatively infrequent sites of metastasis. In a landmark case series, Ferry and Font described 227 cases of carcinoma metastatic to the eyes.1,2 Among these cases, only 28 (12%) were orbital metastases, most frequently from tumors of the breast, lung, and genitourinary tract; in this series, the diagnosis of orbital metastasis preceded the diagnosis of the primary tumor in 61% of cases.2 Metastases represent from 1% to 13% of orbital tumors, the rest being accounted for by primary tumors. We present the case of a patient in whom orbital metastasis was the first manifestation of cancer.

Complete response to radiation therapy of orbital metastasisfrom hepatocellular carcinoma

“…Orbital metastases are uncommon and account for 3%-7% of all orbital neoplasms [7,10,11] . The most common symptoms of orbital metastases include pain, proptosis, decreased vision or blindness, diplopia, displacement of the globe, exophthalmos, and occasionally enophthalmos.…”

“…The most common symptoms of orbital metastases include pain, proptosis, decreased vision or blindness, diplopia, displacement of the globe, exophthalmos, and occasionally enophthalmos. HCC very rarely metastasizes to the orbits, and only a total of 14 case reports of orbital metastases from HCC have been described (Table 2) [4][5][6][7][8][9][10][11][12][13][14][15] . Orbital metastases are usually associated with advanced disease and early mortality.…”

“…The average survival after occurrence of the orbital metastases is approximately 10 mo [11] , although the prognosis ultimately depends on the systemic tumor burden [5] . Among the 14 reported cases of orbital metastases from HCC (Table 2) [4][5][6][7][8][9][10][11][12][13][14][15] , only 4 received primary radiation as the palliative treatment in doses ranging from 30 to 54 Gy, and all showed a response. However, specific details of the radiation planning and treatment delivery in this challenging location are not available.…”

“…However, specific details of the radiation planning and treatment delivery in this challenging location are not available. Long-term effects of treatment are poorly understood because only one of the patients survived longer than 1 year after treatment [11,13] . Our patient received a higher dose of radiation than used in the above case reports, and was the first to use IMRT for treatment of orbital HCC metastasis.…”

“…Srinivasan et al [4] F 76 None NA Scolyer et al [23] M 77 None NA Font et al [13] F 79 Palliative RT 3 yr Kim et al [6] F 56 None 2 mo Machado-Netto et al [11] M 57 Megestrol acetate and Gemcitabine…”