Unilateral Blepharoptosis from Renal Cell Carcinoma

Greco, Federico; Sabatino, Lorenzo; Sabatino, Francesco; Casale, Manuele; Quattrocchi, Carlo Cosimo; Zobel, Bruno Beomonte

doi:10.15586/jkcvhl.2016.61

Cited by 6 publications

(5 citation statements)

References 23 publications

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“…MRI and CT are very importance for the diagnosis, the staging of the disease and for the choice of the site where you can make the cytological or histological specimen. In our case the cytology confirmed the diagnosis of renal cell carcinoma [12]. …”

supporting

confidence: 76%

“…We have presented a case of a 47-year-old patient with unilateral left blepharoptosis and blurred vision, due to an OM from RCC [12].…”

Section: Short Communicationmentioning

confidence: 99%

“…Consequently, cytology in specimens taken at the lymph-node stations 7 and 11 L through endoscopic ultrasound has placed diagnosis of RCC [12].…”

Section: Short Communicationmentioning

confidence: 99%

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Orbital Secondary Lesion from Renal Cell Carcinoma

Federico¹,

Lorenzo²,

Manuele³

et al. 2017

J Kidney

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The most common sites of metastasis of renal cell carcinoma are lungs, locoregional lymph nodes, bone and liver. Renal cell carcinoma rarely metastasizes in head and neck sites. We have reported a case of a patient of 47-year-old man who presented with unilateral blepharoptosis and blurred vision due to metastatic renal cell carcinoma to the orbit. The imaging techniques used have been fundamental for the diagnosis, staging and of the choice of the cytological sampling site.Keywords Blepharoptosis; Kidney cancer; Orbital magnetic resonance imaging; Ptosis; Renal cell carcinoma Short CommunicationKidney cancer constitutes the 2-3% of all malignant tumors in adults and the third most frequent cancer of the urinary tract [1][2][3]. Male-Female ratio is about two to one (M/F: 2:1), and the mean age at diagnosis is in the early 60 years [2,4].From 25 to 33% of patients with renal cell carcinoma (RCC) present metastasis at first diagnosis [5]; the most common localizations of metastatic sites are lungs (75%), regional lymph nodes (65%), bone and liver (both 40%). Cases with metastatic localization in the head and neck region are 15% [6].From 1% to 13% of orbital tumors is metastasis [7]. Studies conducted in different countries demonstrate as from 3% to 10% of the orbital metastasis (OM) derived from the kidney [8][9][10][11].We have presented a case of a 47-year-old patient with unilateral left blepharoptosis and blurred vision, due to an OM from RCC [12].Brain magnetic resonance imaging (MRI) showed an expansive solid lesion located at the left orbit roof likely to be extraconal bone origin (diameters of 23 × 15 × 25 mm). This lesion was isointense on T1 and T2-weighted images, showing contrast enhancement and intraorbital expansion at the upper-outer quadrant level. The lesions incorporated the lacrimal gland and were not visible cleavage planes from the upper rectus, lateral rectus and the upper eyelid muscle in (Figure 1).Total body computed tomography (CT) showed in many secondary mediastinal lymphadenopathies, a partially exophytic lesion located in the upper pole of the left kidney (diameters 72 × 56 × 70 mm) with necrosis in context that marks the upper caliceal group (Figures 2), two metastases at the body and medial arm of the left adrenal gland, a nodulation in the right adrenal gland, loco regional lumbar-aortic lymphadenopathy and many bone metastases in the skeletal portions studied. Consequently, cytology in specimens taken at the lymph-node stations 7 and 11 L through endoscopic ultrasound has placed diagnosis of RCC [12].Orbital metastasis, generally, comes as orbital mass, exophthalmos, lid edema, ptosis, diplopia and/or cranial nerve paralysis [13].In this case, symptoms such as blurred vision and unilateral ptosis hid a systemic malignancy. MRI and CT are very importance for the diagnosis, the staging of the disease and for the choice of the site where you can make the cytological or histological specimen. In our case the cytology confirmed the diagnosis of renal cell carcinoma [12].

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supporting

confidence: 76%

“…We have presented a case of a 47-year-old patient with unilateral left blepharoptosis and blurred vision, due to an OM from RCC [12].…”

Section: Short Communicationmentioning

confidence: 99%

See 1 more Smart Citation

Orbital Secondary Lesion from Renal Cell Carcinoma

Federico¹,

Lorenzo²,

Manuele³

et al. 2017

J Kidney

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“…In some reports, patients presented with orbital metastasis many years after initial diagnosis with RCC [6,8,11]. In others, symptoms due to orbital metastasis were actually the only presenting signs of RCC [4,9-13].…”

Section: Discussionmentioning

confidence: 99%

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

Shahid

Kalayanamitra

Groff

et al. 2019

Cureus

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Renal cell carcinoma (RCC) represents 90% of all renal cancers. Patients may present with weight loss, hematuria, abdominal mass, abdominal pain, fever, and night sweats. The classic symptoms of flank pain, hematuria, and a palpable flank mass occur in less than 10% of patients and suggest advanced disease. However, most patients are typically asymptomatic and diagnosed incidentally. RCC metastasizes most commonly to the lung parenchyma, bone, liver, and brain and less commonly to the thyroid, pancreas, muscle, skin, and soft tissue. It is very rare for RCC to metastasize to the orbital bone. We present a case of a patient who presented with left cheek pain, tingling, and numbness and was ultimately found to have orbital metastasis of RCC.

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“…Failure of the mechanical ptosis to resolve or suspicion for malignancy should prompt the clinician to pursue an orbital MRI with fat suppression and gadolinium contrast for better characterization [17] . Primary and metastatic eyelid malignancies such as Merkel cell carcinoma, sebaceous cell carcinoma, scirrhous breast cancer, small cell lung carcinoma, prostate carcinoma, renal cell carcinoma, medullary thyroid carcinoma, and lymphoma have all been documented to initially present to the clinical setting under the guise of ptosis [53][54][55][56][57] .…”

Section: Mechanical Ptosismentioning

confidence: 99%