Orbital metastasis of squamous cell cervical cancer: A case report and review of literature

Mendia, Ana; Shah, Chintan; Grajo, Joseph R.; Yachnis, Anthony T.; Yeung, Anamaria R.; Cardenas-Goicoechea, Joel; Murphy, Martina

doi:10.1016/j.gore.2020.100689

Cited by 5 publications

(6 citation statements)

References 11 publications

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“…Ocular metastases from UCC are extremely rare. To the best of our knowledge, 23 cases of ocular metastasis from uterine UCC have been reported in the literature [ 5 – 27 ] ( Table 1 ). In these 23 cases, the most common site of ocular metastasis was the orbit (13 cases, 56%), followed by the choroid (6 cases, 26%).…”

Section: Discussionmentioning

confidence: 99%

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Uncommon Hematogenous Metastasis: Orbital Involvement in Uterine Cervical Cancer

Yamaguchi,

Koizumi,

Kakuda

et al. 2023

Am J Case Rep

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Patient: Female, 70-year-old Final Diagnosis: Uterine cervical cancer Symptoms: Sight loss and exophthalmos Clinical Procedure: — Specialty: Obstetrics and Gynecology Objective: Rare disease Background: Although screening for uterine cervical cancer (UCC) and vaccination programs for human papilloma virus (HPV) have been implemented in many countries, women >65 years may not have access to or comply with cervical cancer screening. Women >65 years may present with advanced-stage cervical carcinoma with a poor outcome. Metastatic UCC is often diagnosed, and there are 2 types of metastases related to different treatments and survival rate: hematogenous metastasis and lymphatic metastasis. Hematogenous metastasis is relatively unusual, and it most commonly involves lung and bone locations. Orbital metastasis is an extremely rare hematogenous metastasis in patients with UCC. Case Report: A 70-year-old woman receiving dialysis presented to a local hospital due to general fatigue for 5 months. She was diagnosed with locally advanced UCC and underwent radiation therapy (RT). Twenty days after RT, skin masses appeared, and 34 days after RT, right exophthalmos induced by an orbital mass appeared. We diagnosed skin and orbital masses as metastases from UCC, and performed RT to the orbital tumor. The tumor shrank and the visual symptoms disappeared. Regrettably, the patient died of cancer 7 months after the orbital RT; however, no eye symptoms recurred until her death. Conclusions: This report describes a rare presentation of UCC with metastasis to the orbit, and highlights that cervical cancer may still present at an advanced stage, particularly in older women. In this case, RT to the orbital metastasis from UCC was effective and contributed to the patient’s quality of life.

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Section: Discussionmentioning

confidence: 99%

“…Orbital metastasis is rare in patients with UCC. To date, only 23 cases have been reported [ 5 – 27 ]. The present report is of a 70-year-old woman with advanced UCC involving the orbit, which was reduced solely by local RT.…”

Section: Introductionmentioning

confidence: 99%

Uncommon Hematogenous Metastasis: Orbital Involvement in Uterine Cervical Cancer

Yamaguchi,

Koizumi,

Kakuda

et al. 2023

Am J Case Rep

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“…While chemotherapy, immunotherapy, and hormonal therapies (for breast and prostate cancers) proved to be significantly effective in concurrently treating both primary tumors and choroidal metastases, their impact on orbital metastases requires further analysis [ 66 , 67 , 68 , 69 ]. We found no significant correlation between systemic therapies and clinical ( p = 0.247) or survival ( p = 0.361) response, perhaps due to the different entry routes of medications into orbital tumors as compared to choroidal tumors [ 1 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Orbital Metastases: A Systematic Review of Clinical Characteristics, Management Strategies, and Treatment Outcomes

Palmisciano

Ferini²,

Ogasawara

et al. 2021

Cancers

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Background: Orbital metastases often lead to severe functional impairment. The role of resection, orbital exenteration, and complementary treatments is still debated. We systematically reviewed the literature on orbital metastases. Methods: PubMed, Scopus, Web-of-Science, and Cochrane were searched upon PRISMA guidelines to identify studies on orbital metastases. Clinical characteristics, management strategies, and survival were analyzed. Results: We included 262 studies comprising 873 patients. Median age was 59 years. The most frequent primary tumors were breast (36.3%), melanoma (10.1%), and prostate (8.5%) cancers, with median time interval of 12 months (range, 0–420). The most common symptoms were proptosis (52.3%) and relative-afferent-pupillary-defect (38.7%). Most metastases showed a diffuse location within the orbit (19%), with preferential infiltration of orbital soft tissues (40.2%). In 47 cases (5.4%), tumors extended intracranially. Incisional biopsy (63.7%) was preferred over fine-needle aspiration (10.2%), with partial resection (16.6%) preferred over complete (9.5%). Orbital exenteration was pursued in 26 patients (3%). A total of 305 patients (39.4%) received chemotherapy, and 506 (58%) received orbital radiotherapy. Post-treatment symptom improvement was significantly superior after resection (p = 0.005) and orbital radiotherapy (p = 0.032). Mean follow-up was 14.3 months, and median overall survival was 6 months. Fifteen cases (1.7%) demonstrated recurrence with median local control of six months. Overall survival was statistically increased in patients with breast cancer (p < 0.001) and in patients undergoing resection (p = 0.024) but was not correlated with orbital location (p = 0.174), intracranial extension (p = 0.073), biopsy approach (p = 0.344), extent-of-resection (p = 0.429), or orbital exenteration (p = 0.153). Conclusions: Orbital metastases severely impair patient quality of life. Surgical resection safely provides symptom and survival benefit compared to biopsy, while orbital radiotherapy significantly improves symptoms compared to not receiving radiotherapy.

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“…Distant metastasis of malignant tumors usually occurs in the late stage; however, metastasis to the eyes and skin is extremely rare. Orbits [ 2 ], choroid [ 3 ], and iris [ 4 ] are reported sites of metastatic lesions. Skin metastasis of cervical cancer is very rare, ranging from 0.1% to 2% [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Eyelid Metastasis from Cervical Cancer: A Case Report

Wen,

Huang,

Guo

et al. 2023

Case Rep Oncol

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Metastatic malignant lesions of the eyelids are less than 1% of all eyelid tumors. Eyelid metastasis from the cervix, particularly the first sign of metastasis, has not been reported. A female presented to an ophthalmologist with a gradually increasing mass on the lateral edge of the lower eyelid for 2 months and was diagnosed with stage IB1 cervical cancer 3 years ago. We performed wide local excision of the eyelid mass. The mass was histologically and immunohistochemically similar to cervical cancer. Upon metastatic examination, no lesions involving other sites or lymph nodes were found. Subsequently, local radiation therapy yielded the desired results. In the present case, the possibility of metastasis from the cervix was not considered for the first time. More attention should be paid when identifying unexplained masses in patients with a history of malignant tumors.

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Orbital metastasis of squamous cell cervical cancer: A case report and review of literature

Cited by 5 publications

References 11 publications

Uncommon Hematogenous Metastasis: Orbital Involvement in Uterine Cervical Cancer

Uncommon Hematogenous Metastasis: Orbital Involvement in Uterine Cervical Cancer

Orbital Metastases: A Systematic Review of Clinical Characteristics, Management Strategies, and Treatment Outcomes

Eyelid Metastasis from Cervical Cancer: A Case Report

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