Metastatic eye tumors

Metastatic Tumors in Children

Neuroblastoma

Neuroblastoma is one of the most common malignant tumors in children. Neuroblastoma originates from primitive neuroblasts of the sympathetic trunk more often in the abdominal region, less often in the chest and small pelvis. Neuroblastoma usually affects young children and, as a rule, is already generalized at the time of diagnosis, therefore it has an extremely poor prognosis. Metastases in the orbit can be bilateral, appear suddenly and quickly grow, which is manifested by exophthalmos, the presence of tissue in the upper parts of the orbit and the ecchymosis of the eyelids.

Granulocyte sarcoma (chlorine)

Granulocyte sarcoma - this localized tumor is represented by malignant cells of the myeloid nature. The tumor can have a characteristic green color, which is associated with its former name - chlorine. Granulocyte sarcoma can be a symptom of myeloid leukemia or precede this disease. The first manifestations refer to the age of about 7 years in the form of a rapidly developing exophthalmus, sometimes bilateral, which is often combined with ecchymosis and edema of the century. When orbital damage precedes systemic leukemia, diagnosis is difficult.

Histiocytosis from Langerhans cells (granulomatosis)

This is a rare, poorly researched, multisystem disease, characterized by a destructive inflammatory process with a primary bone lesion. Soft tissues are less involved, but skin and visceral lesions occur. In patients with isolated lesions (eosinophilic granuloma), the disease usually has a benign course and is well treatable. The involvement of the orbit can be unilateral or bilateral, accompanied by osteolysis and the involvement of soft tissues more often in the upper temporal quadrant.

Metastatic tumors in adults

In adults metastases are less frequent in orbit than in the choroid. If the symptomatology begins with an orbit, the ophthalmologist becomes the first doctor to whom the patient addresses. The sources of metastases are (in descending order): the mammary gland, bronchi, prostate gland, skin melanoma, gastrointestinal tract and kidneys.

Symptoms

• The formation in the anterior part of the orbit, which causes the displacement of the eye or exophthalmos, is the most common symptom.
• Infiltration of orbital tissues, characterized by ptosis, diplopia, marked densification of the periorbital skin and tissues of the orbit, which is expressed in the difficulty of repositioning.
• Enophthalmos with scirrhous tumors.
• Chronic inflammatory process in orbit.
• When localized at the apex of the orbit, the function of the cranial nerves (II, III, IV, V, VI) is primarily violated, and the exophthalmos weakly expressed.

Diagnostics

• Fine needle biopsy under CT control is used for histological confirmation. If it is not informative, an open biopsy is performed;
• hormonal studies on tissue samples can be used to develop specific hormone therapy for hormone-dependent tumors.

The goal of the treatment is to preserve vision and fight pain, since most patients die within 1 year.

Radiotherapy is the method of choice. Sometimes, with the ineffectiveness of other methods and intolerable symptoms, the exenteration of the orbit is shown.

Sprouting into the orbit of tumors of the sinuses

Malignant tumors of the pair of nasal sinuses very rarely can sprout into orbit, indicating a poor prognosis even with early diagnosis. In this regard, the doctor is important to understand the otolaryngological and ophthalmological signs of these conditions.

Cancer of the upper jaw is the most frequent sinus tumor, sprouting into the orbit.

• otolaryngological signs: pain in the face, stasis and swelling. Swelling of the face with far-reaching carcinoma of the maxillary sinus, epistaxis and discharge from the nose;
• ophthalmological signs: displacement of the eye upwards, diplopia and epiphary.

Cancer of the sinus can move the eye outwards.

The cancer of the nasopharynx sprouts into orbit through the upper-ophthalmic gap. Exophthalmus joins late.