1
|
Neumann I, Borrelli M, Al Kallaa M, Parker RT, Trigaux C, Teichert N, Geerling G. Rare periorbital, pseudocystic metastasis of squamous cell carcinoma of the bladder: Case report and review of the literature. Orbit 2021; 42:336-342. [PMID: 34913824 DOI: 10.1080/01676830.2021.2012203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We present the case of a man in his fifties with a history of bladder carcinoma who presented with a large periorbital cystic lesion that was found to be a metastasis. Bladder carcinomas are a very rare cause of peri-/orbital metastasis. The primary tumor in this case predominately showed squamous cell differentiation and small areas of adenoid differentiation. To our knowledge only one previous case of orbital metastasis from squamous cell carcinoma of the bladder has been reported. Cyst formation in bladder cancer metastasis has not been reported and is very rare for orbital metastases in general. The pathogenesis of metastatic cyst development is not fully understood and may vary from case to case. A biopsy of an atypical cyst is indicated.
Collapse
Affiliation(s)
- Inga Neumann
- Department of Ophthalmology, University Hospital Duesseldorf, Duesseldorf, Germany
| | - M Borrelli
- Department of Ophthalmology, University Hospital Duesseldorf, Duesseldorf, Germany
| | - M Al Kallaa
- Institute of Pathology, University Hospital Duesseldorf, Germany
| | - R T Parker
- Adnexal Department, Moorfields Eye Hospital, London, UK
| | - C Trigaux
- Department of Ophthalmology, University Hospital Duesseldorf, Duesseldorf, Germany
| | - N Teichert
- Institute of Diagnostic and Interventional Radiology, University Hospital Duesseldorf, Germany
| | - G Geerling
- Department of Ophthalmology, University Hospital Duesseldorf, Duesseldorf, Germany
| |
Collapse
|
2
|
Orbital Metastasis From Urothelial Carcinoma: A Comprehensive Literature Review. Ophthalmic Plast Reconstr Surg 2020; 35:213-217. [PMID: 30489454 DOI: 10.1097/iop.0000000000001256] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To review the clinical features of orbital and choroidal metastases from urothelial carcinomas of the urinary tract among cases reported in the literature, and to describe a case of orbital metastasis from bladder cancer presenting as apparent internuclear ophthalmoplegia. METHODS Case reports of orbital and choroidal metastases from urothelial carcinomas published in the literature from 1965 to 2018 were reviewed. Data collected included patient demographics, cancer stage and primary site, time to onset of ocular symptoms, length of presenting ocular symptoms, types of primary ocular symptoms, diagnostic imaging, histology, systemic and ocular treatments, and survival time. RESULTS Twenty-eight cases of urothelial carcinoma with metastasis to the orbit or choroid were reviewed. Men were significantly more likely to suffer from this condition than women (p = 0.011). The average age of presentation with orbital symptoms was 63 years, with an average time of 19 months between primary cancer diagnosis and onset of orbital symptoms. Twenty-two patients had metastasis to the orbit and 6 to the choroid. In 4 cases, ocular deficits secondary to orbital and/or choroidal metastases were the initial presenting symptoms in patients with previously undiagnosed urothelial carcinoma. The most commonly noted primary ocular symptoms and signs consisted of decreased visual acuity, decreased ocular motility, proptosis, and diplopia. Average survival from onset of ocular symptoms was 4.67 months. CONCLUSIONS Urothelial carcinoma may metastasize to the orbit or choroid; furthermore, its presentation may mimic internuclear ophthalmoplegia. It is recommended that any patient with visual symptoms and known urothelial cancer should undergo expedited workup for metastatic disease.
Collapse
|
3
|
Yadav D, Singh M, Gupta K, Kaur M, Gupta P. A report of orbital metastasis from a urinary bladder adenocarcinoma. Indian J Ophthalmol 2019; 67:1377-1380. [PMID: 31332150 PMCID: PMC6677044 DOI: 10.4103/ijo.ijo_1699_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
A 60-year-old man presented with sudden-onset proptosis of the left eye and intermittent diplopia of 2 months duration. Ophthalmic examination revealed bilateral eyelid retraction, left eye proptosis and a firm, non-tender mass (2 cm × 1.5 cm) in left supero-medial orbit with restricted extraocular movements. Contrast-enhanced computed tomography showed a well-defined, enhancing antero-medial orbital mass which was removed via anterior orbitotomy approach. The histopathology/immunohistochemistry showed adenocarcinoma; metastasis of urothelial origin. The oncology consultation and metastatic workup revealed a urinary bladder carcinoma with distant metastasis. Our patient expired within 6 months of diagnosis. The ophthalmic symptoms due to orbital metastasis may be the first presentation of some cancer patients.
Collapse
Affiliation(s)
- Deepti Yadav
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Manpreet Singh
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Kirti Gupta
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Manpreet Kaur
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pankaj Gupta
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
4
|
Giordano G, Olivieri N, D'Andrea MR, Di Raimo T, Manfrin E, Remo A, Pancione M, Brunelli M, De Santis E, Coppola G, Scarpa A, Coppola L, Parcesepe P. Urothelial bladder carcinoma metastasizing to the eye: A systematic review and case report. Oncol Lett 2019; 17:462-467. [PMID: 30655788 PMCID: PMC6313172 DOI: 10.3892/ol.2018.9579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 08/23/2018] [Indexed: 02/05/2023] Open
Abstract
The eye is a rare site for disseminated malignancies; nevertheless, several tumors may metastasize to ocular structures. Few cases of urothelial and bladder cancer with eye involvement have been described in the literature thus far. The rarity of metastatic ocular localization implies an accurate differential diagnosis among the possible primary tumor sites. However, a specific diagnostic algorithm is not currently available, nor a defined therapeutic approach. Eye metastases are associated with advanced disease and poor prognosis. Physicians should be made aware of the possibility of eye involvement in patients with a past medical history of urothelial bladder cancer associated with ocular symptoms. The present case reports discusses the first documented case, to the best of our knowledge, of an urothelial bladder cancer metastasizing to the retro bulbar region that infiltrates the lacrimal gland. Furthermore, the report provides a systematic qualitative review of the current literature on eye metastases from urothelial bladder cancer using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Collapse
Affiliation(s)
- Guido Giordano
- Oncology Division IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, I-71013 Foggia, Italy
- Biology Department, Federico II University of Naples, I-80134 Naples, Italy
- Medical Oncology Unit, San Filippo Neri Hospital, I-00135 Rome, Italy
- Dr Guido Giordano, Oncology Division IRCCS Casa Sollievo della Sofferenza, Viale Cappuccini 1, San Giovanni Rotondo, I-71013 Foggia, Italy, E-mail:
| | - Nunzio Olivieri
- Biology Department, Federico II University of Naples, I-80134 Naples, Italy
| | | | - Tania Di Raimo
- Medical Oncology Unit, San Filippo Neri Hospital, I-00135 Rome, Italy
| | - Erminia Manfrin
- Department of Diagnostics and Public Health-Section of Pathology, University and Hospital Trust of Verona, I-37134 Verona, Italy
| | - Andrea Remo
- Pathology Unit, Mater Salutis Hospital, ULSS9, Legnago, I-37045 Verona, Italy
| | - Massimo Pancione
- Department of Sciences and Technologies, University of Sannio, I-82100 Benevento, Italy
| | - Matteo Brunelli
- Department of Diagnostics and Public Health-Section of Pathology, University and Hospital Trust of Verona, I-37134 Verona, Italy
| | - Elena De Santis
- Department of Human Anatomy, Sapienza University of Rome, I-00185 Rome, Italy
| | - Giulia Coppola
- Department of Human Anatomy, Sapienza University of Rome, I-00185 Rome, Italy
| | - Aldo Scarpa
- Department of Diagnostics and Public Health-Section of Pathology, University and Hospital Trust of Verona, I-37134 Verona, Italy
- Pathology Unit, Mater Salutis Hospital, ULSS9, Legnago, I-37045 Verona, Italy
- Department of Sciences and Technologies, University of Sannio, I-82100 Benevento, Italy
- Department of Human Anatomy, Sapienza University of Rome, I-00185 Rome, Italy
- ARC-Net Centre for Applied Research on Cancer, University and Hospital Trust of Verona, I-37134 Verona, Italy
| | - Luigi Coppola
- UOC of Pathologic Anatomy, San Filippo Neri Hospital, I-00135 Rome, Italy
| | - Pietro Parcesepe
- Department of Diagnostics and Public Health-Section of Pathology, University and Hospital Trust of Verona, I-37134 Verona, Italy
- Correspondence to: Dr Pietro Parcesepe, Department of Diagnostics and Public Health-Section of Pathology, University and Hospital Trust of Verona, L.A. Scuro Square 10, I-37134 Verona, Italy, E-mail:
| |
Collapse
|
5
|
Sarmiento JM, Wi MS, Piao Z, Stiner ES. Solitary cerebral metastasis from transitional cell carcinoma after a 14-year remission of urinary bladder cancer treated with gemcitabine: Case report and literature review. Surg Neurol Int 2012; 3:82. [PMID: 22937482 PMCID: PMC3424676 DOI: 10.4103/2152-7806.99172] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Accepted: 02/17/2012] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Brain metastases are the most common adult brain tumors, frequently arising from primary tumors in the lung, breast, skin, kidneys, and colon. Transitional cell carcinoma (TCC), the most common type of urinary bladder cancer, is a rare cause of brain metastasis with an ominous prognosis. CASE DESCRIPTION A 68-year-old female presented with right-sided paresis and focal motor seizures of her right upper and lower extremities 14 years after being diagnosed and treated for primary TCC of the urinary bladder with gemcitabine-based chemotherapy. MRI imaging revealed a 3.1 × 3.1 × 2.7 cm heterogeneously enhancing mass located along the posterior aspect of the left frontal convexity. The lesion was accessed using a transsulcal approach and was surgically debulked along the motor cortex with motor strip mapping, followed by adjuvant whole-brain radiation therapy. Pathological examination confirmed metastatic carcinoma with features of TCC, a rare entity among metastatic brain tumors. CONCLUSION Brain metastases may present several years later in patients with TCC of the urinary bladder who have been treated with surgery and chemotherapy. Chemotherapeutic agents that penetrate the blood-brain barrier, such as gemcitabine, may delay development of cerebral metastasis from primary TCC of the urinary bladder.
Collapse
Affiliation(s)
| | - Matt S. Wi
- Department of Biochemistry and Molecular Biology, University of California, Riverside, USA
| | - Zhe Piao
- Department of Pathology, Kaiser Fontana Medical Center, Fontana, CA, USA
| | - Eric S. Stiner
- Department of Neurosurgery, Kaiser Fontana Medical Center, Fontana, CA, USA
| |
Collapse
|
6
|
|
7
|
Orbital metastasis of keratinizing squamous cell cervical carcinoma with giant cells. A case report. Int Ophthalmol 2007; 29:39-44. [PMID: 17975710 DOI: 10.1007/s10792-007-9162-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2007] [Accepted: 10/08/2007] [Indexed: 10/22/2022]
Abstract
A case of orbital metastasis of cervical keratinizing squamous cell carcinoma is presented. The patient, in remission from primary cervical and ovarian cancers, presented with complaints of left eye ptosis and pain. Examination revealed the presence of a moderately tender mass along the left supra-temporal orbital rim and downward displacement of the left globe. Computed tomography revealed a poorly circumscribed mass with superior lateral wall bone loss. Excised tissue contained invasive, poorly differentiated nests of pan keratin and epithelial membrane antigen-positive squamous cells with numerous pleomorphic multinucleated giant cells. Multiple treatment regimes were unsuccessful, and the patient expired due to disease complications after 3 months.
Collapse
|
8
|
Zwicker F, Herfarth K, Debus J. [Palliative radiotherapy for a retrobulbar metastasis from a urinary bladder carcinoma]. Ophthalmologe 2007; 105:170-2. [PMID: 17541601 DOI: 10.1007/s00347-007-1531-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Retrobulbar metastases from transitional cell carcinoma of the urinary bladder are very rare. This is a case report of palliative radiotherapy successfully reducing acute clinical symptoms such as proptosis, dysfunction of the eye muscles and diplopia in a 50-year-old male patient with a retrobulbar metastasis from transitional cell carcinoma. Radiotherapy quickly ameliorated the proptosis and dysfunction of the eye muscles without side effects. The patient's quality of life was clearly improved.
Collapse
Affiliation(s)
- F Zwicker
- Abt. für Radioonkologie und Strahlentherapie, Radiologische Klinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
| | | | | |
Collapse
|
9
|
Lin HC, Chang CH, Li WM, Hsiao HL, Chang TH, Wu WJ, Huang CH. Orbital Metastasis from Urothelial Carcinoma of the Urinary Bladder. Kaohsiung J Med Sci 2007; 23:84-8. [PMID: 17339171 DOI: 10.1016/s1607-551x(09)70380-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Radical cystectomy with ileal conduit diversion remains the standard treatment for invasive bladder cancer. We report a patient with urothelial carcinoma of the urinary bladder and found metastasis to the orbit post radical cystectomy and ileal conduit diversion presenting as blurred vision and diagnosed by open biopsy. The orbit is an infrequent site of metastasis from bladder cancer cells. To the best of our knowledge, there are fewer than 10 case reports of orbital metastasis from urothelial carcinoma reported in the English medical literature.
Collapse
Affiliation(s)
- Han-Ching Lin
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | | | | | | | | | | | | |
Collapse
|
10
|
Shikishima K, Miyake A, Ikemoto I, Kawakami M. Metastasis to the Orbit from Transitional Cell Carcinoma of the Bladder. Jpn J Ophthalmol 2006; 50:469-473. [PMID: 17013702 DOI: 10.1007/s10384-006-0342-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2006] [Accepted: 04/20/2006] [Indexed: 11/26/2022]
Abstract
PURPOSE To demonstrate the pathological features of the extremely rare metastatic transitional cell carcinoma (TCC) from the bladder to the orbit, and to review the literature on metastatic TCC to the orbit. METHODS A 74-year-old man experienced 2 weeks of red eye, proptosis, diplopia, pain, and visual loss in the right eye. Three years previous to the current presentation, the patient had undergone a transurethral resection for superficial and moderately differentiated TCC of the bladder. A transseptal anterior orbitotomy was performed. RESULTS Histopathological examination of the orbital lesion revealed nests of carcinomatous cells. Atypical pleomorphic cells with vacuolated cytoplasm were evident. The cellular morphology of the orbital lesion was identical to that of the primary TCC. There have been 12 previously reported cases of metastases to the orbit from TCC of the bladder, with the time from onset of primary TCC to observation of ocular symptoms ranging from 3 weeks to 11 years. Mean survival after orbital metastasis developed from TCC was 3.0 months. CONCLUSION This study presents a detailed description of the pathological features of metastatic TCC in the orbit. In cases of orbital metastasis from TCC, patient prognosis is very poor.
Collapse
Affiliation(s)
- Keigo Shikishima
- Department of Ophthalmology, Jikei University School of Medicine, Tokyo, Japan.
| | - Akira Miyake
- Department of Ophthalmology, Jikei University School of Medicine, Tokyo, Japan
| | - Isao Ikemoto
- Department of Urology, Jikei University School of Medicine, Tokyo, Japan
| | - Makio Kawakami
- Department of Pathology, Clinical Service, Jikei University School of Medicine, Tokyo, Japan
| |
Collapse
|