Renal Cell Carcinoma Metastasis to an Uncommon Site: The Orbital Bone

Shahid, Zainab; Kalayanamitra, Ricci; Groff, Andrew; Khalid, Muhammad; Jain, Rohit

doi:10.7759/cureus.4606

Cited by 1 publication

(1 citation statement)

References 13 publications

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“…The list of our own and published lesions appears in Table 2. 2–99 Published cases of 4 of the listed diagnoses were not reviewed because there is a significant literature on these already (sickle cell crisis with sphenoid infarction, tuberculosis of orbital bone, sphenoid bone dysplasia in NF1, and fibrous dysplasia of bone). During the same period as these new cases were collected from our practices, 97 cases (21 males) of spheno-orbital meningioma were encountered by us.…”

Section: Resultsmentioning

confidence: 99%

Spheno-orbital Lesions—A Major Review of Nonmeningioma Causes

McNab

Jones

Hardy

2021

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Purpose: To review the imaging features of the broad range of nonmeningioma lesions of the greater wing of the sphenoid (GWS) bone and adjacent orbit to assist clinicians in differentiating these lesions from each other and from the most common lesion of the GWS and adjacent orbit, meningioma. Methods: We reviewed 32 cases of spheno-orbital lesions involving the GWS from our own practice, as well as 109 published cases (total 141), with emphasis on available imaging features on computerized tomography (CT) and MRI. Features that might assist in differentiating meningioma from its mimics were analyzed for each lesion, including the presence of an osteoblastic or hyperostotic response, bone erosion or osteolysis, homogeneous hypo- or hyperintensity on T2-weighted MRI, leptomeningeal involvement, and the absence of a “dural tail” on contrast-enhanced MRI. The clinical and imaging features were also briefly summarized for each diagnostic group. Results: The largest diagnostic group was metastasis (67 cases, 47.5%). The most useful imaging features that helped differentiate meningioma from its mimics were the presence of bone erosion and the absence of a “dural tail.” Other features were helpful in a small minority of cases only. Metastatic prostate cancer was the largest single group (21 cases), and 18 (85.7%) of these were osteoblastic and most closely mimicked meningioma. Prostate cancer patients were generally older than males with GWS meningioma. Almost all other (44/46, or 95.7%) metastatic lesions showed evidence of bone erosion. Almost half (30 of 61, 49.2%) of patients with metastasis presented without a known diagnosis of malignancy. Among children 16 years of age and less, Langerhans cell histiocytosis (10 cases), dermoid cyst (5), and Ewing’s sarcoma (5) were the most common diagnoses. Conclusions: A combination of a careful history and both CT and MRI gives information, which can best guide the management of patients with spheno-orbital lesions. Metastatic prostate cancer to the GWS most closely mimics GWS meningioma but can in most cases be differentiated on clinical and imaging features. Older males with hyperostotic lesions of the GWS should be investigated for prostate cancer. Other metastatic lesions and primary tumors of the GWS, as well as benign and structural lesions can readily be differentiated from meningioma on clinical and imaging features.

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Section: Resultsmentioning

confidence: 99%