Orbital neuroblastoma metastasis

Yang, Wendi; Zhou, Yuanyuan; Zhao, Fang; Mei, Zhong-Ming; Li, Shuang; Xiang, Yi

doi:10.1097/md.0000000000017038

Cited by 18 publications

(15 citation statements)

References 16 publications

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“…Otras afecciones, como la trombosis de la vena oftálmica superior y las metástasis del seno cavernoso, son menos frecuentes, pero no improbables. El diagnóstico diferencial mediante la clínica resulta difícil, sobre todo cuando no hay antecedente de trauma ni de infección 3,[6][7][8] , y en estos casos la RM es la herramienta más sensible y específica [8][9][10][11] . La primera paciente que aquí reportamos tuvo un cuadro que sugería patología orbitaria, con una presentación aguda, presuntamente de naturaleza inflamatoria o vascular; sin embargo, los síntomas y los signos fueron insuficientes para presumir la causa, por lo que la RM tuvo un papel fundamental en el diagnóstico etiológico.…”

Section: Discussionunclassified

Causas infrecuentes de proptosis aguda dolorosa. Reporte de casos

Maimó-Gallego¹,

Riesgo²,

Bory-Vargas³

et al. 2023

RMO

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Introducción: Los trastornos del drenaje venoso orbitario incluyen proptosis de inicio brusco, edema de los párpados, dilatación de los vasos venosos epiesclerales, hipertensión ocular y oftalmoplejía. La resonancia magnética es el mejor método para identificar la causa. Casos clínicos: Se reportan dos casos inusuales, en pacientes de 54 y 56 años de edad. Se presentaron con proptosis dolorosa aguda. Uno de ellos desarrolló edema de párpados, quemosis, dilatación y tortuosidad de los vasos venosos epiesclerales, así como hipertensión ocular. En este caso se detectó una trombosis de la vena oftálmica superior izquierda. El segundo paciente experimentó síntomas clínicos similares, pero se diagnosticó una metástasis en el seno cavernoso izquierdo. Estas afecciones son diferentes variantes de trastornos del drenaje venoso orbitario con un comportamiento clínico similar, aunque de diferentes causas. Estos diagnósticos deben considerarse en todo paciente con proptosis aguda dolorosa. Se han reportado pocos casos en la literatura.

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Section: Discussionunclassified

Causas infrecuentes de proptosis aguda dolorosa. Reporte de casos

Maimó-Gallego¹,

Riesgo²,

Bory-Vargas³

et al. 2023

RMO

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“…Only 8% of neuroblastoma cases present with orbital signs. In the largest review of cases with orbital involvement, there were 10 patients and periorbital ecchymosis (racoon eyes) was the most common finding, followed by proptosis . Other findings included periorbital edema, subconjunctival hemorrhage, vision loss, and decreased ocular motility .…”

Section: Discussionmentioning

confidence: 99%

“…In the largest review of cases with orbital involvement, there were 10 patients and periorbital ecchymosis (racoon eyes) was the most common finding, followed by proptosis . Other findings included periorbital edema, subconjunctival hemorrhage, vision loss, and decreased ocular motility . Neuroblastoma can also cause a paraneoplastic syndrome leading to cerebellar dysfunction and opsomyoclonus …”

Section: Discussionmentioning

confidence: 99%

“…High-risk neuroblastoma is relegated to a 30% to 40% survival . Orbital metastasis are associated with poor prognosis and can be misdiagnosed as orbital fractures, child abuse, benign hemorrhages, or other tumors . Ophthalmologists can play a role in diagnosing neuroblastoma and should promptly refer to a pediatrician or oncologist when neuroblastoma is suspected.…”

Section: Discussionmentioning

confidence: 99%

“…3 Other findings included periorbital edema, subconjunctival hemorrhage, vision loss, and decreased ocular motility. 3 Neuroblastoma can also cause a paraneoplastic syndrome leading to cerebellar dysfunction and opsomyoclonus. 1 Diagnostic workup includes computed tomography (CT) and/or magnetic resonance imaging, urine homovanillic and vanillylmandelic acid tests, iodine-131-meta-iodobenzylguanidine (I-MIBG) scan for bone involvement, and bone marrow or primary tissue biopsy.…”

mentioning

confidence: 99%

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Bilateral Upper Eyelid Ecchymosis and Edema in a 13-Month-Old

2022

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A 13-month-old boy with an unremarkable medical history and no ocular history was brought to the emergency department by his parents for bilateral eyelid ecchymosis and edema for 1 month, as well as a mass on the right temporal area that was persistent for the past month and a half. He had hit the right side of his head on a table 1 month before symptoms developed, but had no other recent trauma. The mass had not changed in size, was not tender, and had no other associated symptoms. His parents had not noticed any change in vision. At bedside, the patient was playful and in no acute distress. On examination, he fixed and followed in each eye. His pupils were equal and reactive to light without afferent pupillary defect. Both eyes were soft to palpation and his extraocular movements were full. Externally, his examination was notable for bilateral upper eyelid ecchymosis and edema, as well as a soft, well-circumscribed mass on the right temporal region (Figure 1). There was no obvious proptosis. He was also noted to have subconjunctival hemorrhage temporally on the right eye. Otherwise, findings of his anterior examination and dilated fundoscopic examination were normal. Diagnosis Metastatic neuroblastoma What to Do Next A. Brain/orbital imaging DiscussionBilateral orbital ecchymosis without trauma in a young child warranted suspicion for neuroblastoma. This, in addition to the temporal mass, prompted urgent imaging and full ophthalmologic examination. Differential diagnoses include neuroblastoma, hematoma, rhabdomyosarcoma, hemangioma, cyst, or bleeding diathesis. While bleeding diathesis could cause ecchymosis and subconjunctival hemorrhage (D), the temporal mass indicates that the hemorrhages may represent a more ominous finding. Reassurance (B) or contacting Child Protective Services (C) is inappropriate before further workup.

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Mandibular metastases in neuroblastoma: Outcomes and dental sequelae

Singh

Modak

Solano

et al. 2021

Pediatric Blood & Cancer

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Background Although metastatic involvement of bony sites including cranial bones is common in neuroblastoma (NB), mandibular metastases (MM) are uncommon, and specific outcomes have not been reported upon in the modern therapeutic era. Methods In this retrospective study, medical records on patients with MM from NB were reviewed. Statistical analysis was performed using the Kaplan‐Meier method. Results Of 29 patients, nine (31%) had MM at diagnosis, whereas in 20 (69%) MM were first detected at NB relapse at a median time of 26 (6‐89) months from diagnosis. Median maximal diameter of lesions was 3 (range 0.8‐4.9) cm. MM were unilateral in 83% of patients, with ascending ramus (55%) and mandibular body (38%) being the two most common sites. All patients received systemic chemotherapy, and 26 (93%) patients received radiotherapy to MM. At a median follow‐up of 37.3 (24.2‐219.5) months, eight of nine patients with MM at diagnosis did not experience mandibular progressive disease. Eighteen of 20 patients with MM at relapse received therapeutic radiotherapy; objective responses were noted in 78%. Seventy‐two percent (5/18) had not experienced relapse within the radiation field at a median of 12 (2‐276) months postradiotherapy. Dental findings at follow‐up after completion of NB therapy included hypodontia, hypocalcification of enamel, and trismus. Median 3‐year overall survival in patients with relapsed MM was 51 ± 12% months from relapse. Conclusion MM when detected at diagnosis is associated with a prognosis similar to that for other skeletal metastases of NB. Radiotherapy is effective for control of MM detected both at diagnosis and relapse. Significant dental abnormalities posttherapy warrant regular dental evaluations and appropriate intervention.

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Orbital neuroblastoma metastasis

Cited by 18 publications

References 16 publications

Causas infrecuentes de proptosis aguda dolorosa. Reporte de casos

Causas infrecuentes de proptosis aguda dolorosa. Reporte de casos

Bilateral Upper Eyelid Ecchymosis and Edema in a 13-Month-Old

Mandibular metastases in neuroblastoma: Outcomes and dental sequelae

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