Makino Kensaku, Tsutsumi Satoshi, Takaki Yuki, Nonaka Senshu, Okura Hidehiro, Ishii Hisato
Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan.
Radiol Case Rep. 2021 Oct 28;17(1):5-12. doi: 10.1016/j.radcr.2021.09.057. eCollection 2022 Jan.
A 69-year-old woman sustained progressive proptosis for 2 months. The patient had undergone surgery for resection of colon cancer 10 years prior, which was considered to have been completely cured 5 years prior. She was also aware of a hard mass in her left breast, but it had been left untreated. Furthermore, she experienced back pain for a month. Blood examination revealed an elevated level of serum carcinoembryonic antigen, at 17.4 ng/mL (< 5). Computed tomography (CT) revealed a tumor occupying the superolateral part of the right orbit, with intratumoral calcifications and destructive changes in the lateral orbital wall. On magnetic resonance imaging, it appeared as a heterogeneously enhancing, extraconal tumor, 44 mm × 31 mm in maximal dimension, extending into the middle fossa and the adjacent subcutaneous region. Fluorodeoxyglucose positron emission tomography/CT revealed abnormal accumulation in the left breast, T12 vertebra, liver, and lung, in addition to the orbital tumor. The patient underwent total tumor resection through a lateral orbitotomy. Histological examination of the tumor was highly suggestive of a metastatic colon cancer. Late metastasis should be assumed as a differential diagnosis that can be determined only through histological verification.
一名69岁女性出现进行性眼球突出2个月。该患者10年前接受过结肠癌切除术，5年前被认为已完全治愈。她还发现左乳有一硬块，但未予治疗。此外，她背痛1个月。血液检查显示血清癌胚抗原水平升高，为17.4 ng/mL（<5）。计算机断层扫描（CT）显示一个肿瘤占据右眼眶的外上部分，肿瘤内有钙化，眼眶外侧壁有破坏改变。在磁共振成像上，它表现为一个不均匀强化的眶外肿瘤，最大尺寸为44 mm×31 mm，延伸至中颅窝和相邻的皮下区域。氟脱氧葡萄糖正电子发射断层扫描/CT显示除眼眶肿瘤外，左乳、T12椎体、肝脏和肺部有异常积聚。患者通过外侧眶切开术进行了肿瘤全切。肿瘤的组织学检查高度提示为转移性结肠癌。应将晚期转移作为一种鉴别诊断，只有通过组织学验证才能确定。
