Mori Hanae, Maekawa Naoko, Satoda Naoki, Otsuka Naoki, Sakai Naoki, Fukuse Tatsuo
Department of Respiratory Medicine, Otsu Red Cross Hospital, Otsu, Japan.
Nihon Kokyuki Gakkai Zasshi. 2003 Jan;41(1):19-24.
We encountered a case of lung cancer in which symptoms due to orbital metastasis were recognized. A 55-year-old man presented with a chief complaint of double vision. Orbital MR image demonstrated a right intraorbital mass with bone destruction, which resulted in oculomotor nerve palsy and optic nerve disturbance. Chest CT scan showed a 4 cm mass in the right S6, which was diagnosed on biopsy as a poorly differentiated adenocarcinoma. A whole-body scintigram revealed multiple bone metastases: the right orbital wall, the lower cervical spine, the left knee joint, and so on. Based on the clinical findings, we believed that the orbital tumor was a metastasis from the lung. Systemic chemotherapy and irradiation of the right orbital tumor and the left knee joint were performed. Though a favorable response was achieved in ocular movement, the patient died 3 months after initial treatment because of progression of the primary lesion. Including this case, seventeen reported cases in which lung cancer metastasized to the orbit in Japan were also reviewed.
我们遇到了一例因眼眶转移而出现症状的肺癌病例。一名55岁男性以复视为主要诉求就诊。眼眶磁共振成像显示右侧眶内有一伴有骨质破坏的肿块，导致动眼神经麻痹和视神经功能障碍。胸部CT扫描显示右肺S6区有一个4厘米的肿块，活检诊断为低分化腺癌。全身骨闪烁显像显示多处骨转移，包括右侧眶壁、下颈椎、左膝关节等。根据临床表现，我们认为眼眶肿瘤是肺部转移所致。对右侧眼眶肿瘤和左膝关节进行了全身化疗及放疗。虽然眼球运动有良好反应，但患者在初始治疗3个月后因原发灶进展而死亡。包括本病例在内，我们还回顾了日本报道的17例肺癌转移至眼眶的病例。
