Metástasis retrorbitaria como manifestación inicial del cáncer de próstata

Abstract

Orbital metastasis is an unusual localization within tumoral dissemination of prostatic cancer. Similarly, it is rare that orbital metastasis might be responsible for the clinic manifestations that determine the initial diagnosis of neoplasia. We illustrate the case of a patient suffering from prostatic adernocarcinoma that displayed alterations of facial sensitivity and right eye exophthalmos. We describe how the final diagnosis was reached and the patient's response to the suppressive hormonal treatment. The patient's rate of survival has proved to be longer than the rest of cases documented, with over 30-month follow-up.

Sphenoid Sinus Metastasis as the Presenting Manifestation of a Prostatic Adenocarcinoma: Case Report and Overview of the Literature

“…A review of periorbital prostatic metastases reported a survival of 16.3 months, showing no statistically significant differences when compared to other prostatic metastases [6]. However, there are cases with longer survival rates [7], as it is our case.…”

“…The most common metastatic sites of the prostatic adenocarcinoma are the pelvic lymphatic nodes and the bones of the axial skeleton. Intracranial metastases are unusual, and when they occur, the diagnosis of prostate cancer is already made and the disease is already disseminated [6]. It is exceptional that a cranial metastasis appears as a first manifestation of a prostate cancer, as it is our case.…”

“…Some authors estimate that up to 10–20% of prostatic tumors are firstly diagnosed by their metastatic manifestations [6]. The way of distant dissemination of the metastases is either lymphatic or hematological.…”

“…Furthermore, it would also justify intracranial dissemination to the leptomeninges, which is the most common intracranial metastatic site. However, in the case of metastases to the orbit, they arrive necessarily from an arterial way [6], by means of tumoral emboli that overcome the pulmonary filter. …”

“…Due to the shortage of cases, there is no current standard of care for these patients. On the other hand, the early start of the treatment seems to produce a better control of the symptoms [6]. Radiotherapy alone or combined with androgen deprivation allows a rapid regression of the symptoms.…”