Department of Ophthalmology, Kaohsiung Armed Forces General Hospital, Kaohsiung 802, Taiwan.
Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan.
Medicina (Kaunas). 2021 Nov 12;57(11):1238. doi: 10.3390/medicina57111238.
Orbital metastasis from ampullary carcinoma is rare, with no previously reported cases.
We report the case of a 60-year-old man who complained of a right-sided headache, blurred vision, progressive proptosis, ptosis, and right eye pain for 3 months. His past medical history included an ampullary adenocarcinoma stage IIIA treated via the Whipple procedure and adjuvant chemoradiotherapy 1 year ago. However, he was lost to follow-up. Computed tomography of the orbit showed a soft tissue lesion in the right orbital fossa measuring 3.3 × 2 × 2 cm. An orbital mass biopsy demonstrated an intestinal-type adenocarcinoma that tested positive for cytokeratins 7 and 20 and CDX2 on immunohistochemical staining. The pathologic diagnosis was metastatic adenocarcinoma from the ampulla of Vater. Despite oncological treatment, the patient's illness progressed. He received palliative treatment and died 1 month later.
We presented a rare case of orbital metastasis from ampullary adenocarcinoma. This should be considered in the differential diagnosis of patients with a history of ampullary adenocarcinoma who present with symptoms referring to the relevant locations.
壶腹癌发生眼眶转移较为罕见，目前尚无相关报道。
我们报告了 1 例 60 岁男性患者，3 个月来他主诉右侧头痛、视力模糊、进行性眼球突出、上睑下垂和右眼疼痛。患者既往有壶腹腺癌病史，ⅢA 期，1 年前接受了 Whipple 手术和辅助放化疗，但此后失访。眼眶 CT 显示右侧眶窝内有一 3.3×2×2cm 的软组织病变。眼眶肿块活检显示肠型腺癌，免疫组织化学染色显示细胞角蛋白 7 和 20 以及 CDX2 阳性。病理诊断为壶腹腺癌转移性。尽管进行了肿瘤治疗，患者的病情仍在进展。他接受了姑息治疗，1 个月后死亡。
我们报告了 1 例罕见的壶腹腺癌眼眶转移病例。对于有壶腹腺癌病史且出现相关部位症状的患者，应考虑到这种情况。
