McCulley Timothy J, Yip Chee-Chew, Bullock John D, Warwar Ronald E, Hood Daniel L
Department of Ophthalmology, University of California, Irvine, Irvine, California 92697, USA.
Ophthalmic Plast Reconstr Surg. 2002 Sep;18(5):385-7. doi: 10.1097/00002341-200209000-00013.
To describe a case of orbital metastasis from an undifferentiated pelvic tumor with probable cervical origination.
Case report. Detailed ophthalmologic examination, orbital CT and MRI, and orbital biopsy with histologic and immunohistochemical analysis.
A 29-year-old woman with a history of untreated cervical dysplasia was hospitalized with flank pain, hematuria, and abnormal vaginal bleeding. Biopsy of a large mass, protruding from the cervix as a grape-like cluster, had cellular morphology and immunohistochemical staining patterns consistent with cervical cancer. Diplopia in downgaze developed shortly after hospitalization. Ophthalmic examination was notable for mild right lower eyelid fullness, 1.5 mm right relative proptosis, and a deficit in supraduction and infraduction of the right eye. Orbital MRI and CT revealed a 1.2 x 1.6-cm mass immediately inferior and posterior to the right globe without bone involvement. On biopsy, the mass had histology similar to that of the pelvic tumor. On metastatic workup, lesions were found involving the left femoral head, liver, and spinal column, with adjacent lymphadenopathy. Despite treatment with radiation and chemotherapy, the patient died several months later of causes related to the systemic disease.
Orbital metastasis of cancer originating in the cervix, despite its rarity, should be considered when an orbital mass of unknown cause is present.
描述一例可能起源于宫颈的未分化盆腔肿瘤发生眼眶转移的病例。
病例报告。进行详细的眼科检查、眼眶CT和MRI检查，并进行眼眶活检及组织学和免疫组化分析。
一名29岁有未经治疗的宫颈发育异常病史的女性因胁腹痛、血尿和异常阴道出血入院。对一个从宫颈突出呈葡萄状簇的大肿块进行活检，其细胞形态和免疫组化染色模式与宫颈癌一致。住院后不久出现向下注视时复视。眼科检查发现右眼下睑轻度饱满、右眼相对突出1.5mm，右眼上转和下转功能受限。眼眶MRI和CT显示在右眼球下方和后方有一个1.2×1.6cm的肿块，无骨质受累。活检显示该肿块组织学与盆腔肿瘤相似。在转移灶检查中，发现病变累及左股骨头、肝脏和脊柱，并伴有相邻淋巴结病。尽管接受了放疗和化疗，患者数月后因与全身疾病相关的原因死亡。
当出现原因不明的眼眶肿块时，应考虑起源于宫颈的癌症发生眼眶转移，尽管这种情况罕见。
