Oculoplastic and Facial Cosmetic Surgery, EyePlasTX, San Antonio, Texas, USA.
Ophthalmology, Berkley Eye Center, Corpus Christi, Texas, USA.
Orbit. 2022 Oct;41(5):637-641. doi: 10.1080/01676830.2021.1914671. Epub 2021 Apr 19.
A 53-year-old woman was referred to the authors with a history of left eyelid swelling and retro-orbital pain. She had a history of a prior stomach gastrointestinal stromal tumor (GIST) with metastasis to the liver and intrahepatic bile duct. Examination showed global motility restriction with no relative afferent pupillary defect, and exophthalmometry confirmed 4 mm of left-sided proptosis. Computed tomography imaging showed a heterogeneous mass involving the left inferior rectus muscle with extension to the optic nerve measuring 32.5 mm anterior to posterior and abnormal thickening of the right inferior rectus muscle. An incisional biopsy was performed through a left inferior orbitotomy. Histopathological examination revealed an orbital mass with epithelioid morphology consistent with a metastatic GIST. Immunohistochemical analysis revealed positivity for CD-117 and Dog-1, and negativity for Myogenin. This represents the fifth biopsy-proven GIST metastatic to the orbit in the literature, only the second case with predominantly epithelioid morphology, and only the second case with bilateral orbital metastasis. The authors detail the relevant clinical history, imaging, and pathology.
一位 53 岁女性因左眼肿胀和眼眶后疼痛被转介给作者。她曾患有胃胃肠道间质瘤（GIST）病史，伴肝内和肝内胆管转移。检查显示眼球运动受限，无相对传入性瞳孔缺陷，眼球突出度测量证实左侧眼球突出 4 毫米。计算机断层扫描成像显示涉及左眼下直肌的异质性肿块，延伸至视神经，前后径为 32.5 毫米，右眼下直肌异常增厚。通过左眼下眶切开术进行了切开活检。组织病理学检查显示眼眶肿块具有上皮样形态，符合转移性 GIST。免疫组织化学分析显示 CD-117 和 Dog-1 阳性，Myogenin 阴性。这是文献中第五次经活检证实的转移性 GIST 至眼眶，仅第二例以主要上皮样形态出现，且仅第二例双侧眼眶转移。作者详细介绍了相关的临床病史、影像学和病理学。
