Discrete Metastasis of Solid Tumors to Extraocular Muscles

Capone, Antonio; Slamovits, Thomas L.

doi:10.1001/archopht.1990.01070040089037

Cited by 81 publications

(51 citation statements)

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“…The pathophysiology for carcinoid (or other neoplasms) to seed the EOMs versus other components of the orbit is unknown, though some authors speculate, and it seems likely, that an immunologic mechanism or tumor cell adhesion factors in the local cellular microenvironment may play a role. 5,20 Regarding bilateral and multifocal disease, a study by Mehta et al 13 of 13 patients with orbital carcinoid metastases showed that only 2 of 13 patients had bilateral lesions and no quadrant was favored. In contrast, our limited series showed a relatively higher proportion of bilaterality (5 of 7 patients) and a slight predominance of lesions in the lateral rectus.…”

Section: Discussionmentioning

confidence: 42%

“…5,15,18,19 Our experience, combined with the existing ophthalmology literature, suggests a tendency for both intraorbital, extramuscular, and EOM metastatic disease in patients with carcinoid primary tumors. 4,6,8,13,14,17 Reports suggest that uveal tract carcinoid metastases are more commonly noted in bronchial lesions, whereas EOM metastases more commonly occur in gastrointestinal primary carcinoids.…”

Section: Discussionmentioning

confidence: 48%

“…[4][5][6][7][8][9][10][11][12][13] However, by our review of the radiology literature, there is a single dedicated case report detailing the imaging findings for this entity.…”

mentioning

confidence: 42%

“…3 Although rare, metastatic carcinoid to the extraocular muscles has been relatively well described in both retrospective case reports and clinical series in the ophthalmology literature. [4][5][6][7][8][9][10][11][12][13] However, by our review of the radiology literature, there is a single dedicated case report detailing the imaging findings for this entity. 14 Even within the ophthalmology literature, only a handful of reports focus exclusively on metastases involving the EOMs.…”

mentioning

confidence: 42%

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Carcinoid Tumor Metastases to the Extraocular Muscles: MR Imaging and CT Findings and Review of the Literature

Gupta¹,

Chazen²,

Phillips³

2011

AJNR Am J Neuroradiol

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SUMMARY: Although a relatively rare neoplasm, primary carcinoid tumor has an unusual propensity to metastasize to the orbits. Within the orbit, metastatic EOM lesions have been described in scattered reports in the ophthalmology literature but have received little to no attention in the radiology literature. After a retrospective review, we identified CT and MR imaging studies of 7 patients with carcinoid tumor metastatic to the EOM. Our findings suggest that in patients with known carcinoid tumor, well-defined, round, or fusiform masses of the EOM should strongly suggest metastatic involvement. Our series suggests that bilateral lesions may occur and that any EOM can be involved. Knowledge of this pattern of metastatic disease may spare biopsies in some patients, and with current orbit-sparing therapy for patients with localized orbital disease, early and accurate diagnosis can significantly improve patient outcomes.ABBREVIATIONS: CN VI ϭ cranial nerve VI; EOM ϭ extraocular muscle; IO ϭ inferior oblique; IR ϭ inferior rectus; LR ϭ lateral rectus; MR ϭ medial rectus; MRI ϭ MR imaging; N/A ϭ not applicable; SO ϭ superior oblique; SR ϭ superior rectus C arcinoid tumors are rare neuroendocrine neoplasms derived from enterochromaffin cells, which are found primarily in the gastrointestinal tract and bronchial tree.1,2 Liver metastases are the classic presentation of distant disease, which can lead to carcinoid syndrome (flushing, diarrhea, and wheezing) and right-sided valvular heart disease. However as treatment options improve and survival increases, new metastatic patterns have been increasing in frequency.3 Although rare, metastatic carcinoid to the extraocular muscles has been relatively well described in both retrospective case reports and clinical series in the ophthalmology literature. [4][5][6][7][8][9][10][11][12][13] However, by our review of the radiology literature, there is a single dedicated case report detailing the imaging findings for this entity.14 Even within the ophthalmology literature, only a handful of reports focus exclusively on metastases involving the EOMs. 4,8,15 We present the first series detailing the CT and MR imaging findings of carcinoid tumor metastases to the EOMs. Materials and MethodsA waiver of informed consent was obtained from our institutional review board, and in a manner consistent with Health Insurance Portability and Accountability Act regulations, we retrospectively collected clinical data and CT and MR images available from our institution in patients with known carcinoid tumor. In addition, via a survey of head and neck radiologists from collaborating institutions, additional cases were collected. All imaging analyzed for this study was performed from January 2000 through October of 2010.We found a total of 7 patients with known metastatic disease to the EOMs. The primary inclusion criterion was the presence of EOM lesions in patients with known metastatic carcinoid tumor, though the presence of non-EOM intraorbital disease was not considered an exclusion criterion. ...

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Section: Discussionmentioning

confidence: 42%

Section: Discussionmentioning

confidence: 48%

“…[4][5][6][7][8][9][10][11][12][13] However, by our review of the radiology literature, there is a single dedicated case report detailing the imaging findings for this entity.…”

mentioning

confidence: 42%

mentioning

confidence: 42%

See 2 more Smart Citations

Carcinoid Tumor Metastases to the Extraocular Muscles: MR Imaging and CT Findings and Review of the Literature

Gupta¹,

Chazen²,

Phillips³

2011

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

show abstract

“…Capone and Slamovits reported on five cases where pain, diplopia, and proptosis were the most common presenting manifestations of orbital metastases [5].…”

Section: Discussionmentioning

confidence: 42%