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Wang TT, Chen XY, Min QY, Han YZ, Zhao HF. Iris metastasis from clear cell renal cell carcinoma: A case report. World J Clin Cases 2023; 11:8535-8541. [PMID: 38188215 PMCID: PMC10768508 DOI: 10.12998/wjcc.v11.i36.8535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/14/2023] [Accepted: 12/12/2023] [Indexed: 12/22/2023] Open
Abstract
BACKGROUND Clear cell renal cell carcinoma (ccRCC) is a common type of tumor that can metastasize to any organs and sites. However, it is extremely rare for ccRCC to metastasize to the iris. Here, we describe a rare case of iris metastasis from ccRCC with a history of left nephrectomy in 2010. CASE SUMMARY A 62-year-old male was admitted to the hospital due to blurred vision and red eyes, and a mass was found on the iris in the right eye. B-scan ultrasonography revealed a well-bounded high-density lesion at the corner of the anterior chamber at the 3-4 o'clock position. Phacoemulsification with simultaneous intraocular lens implantation and iridocyclectomy was performed in the right eye. The lesion was confirmed to be metastatic ccRCC by histological and immunohistochemical analyses. The patient was still alive at 9 mo after surgical treatment. Ocular metastasis can be an initial sign with a poor prognosis. Timely detection and treatment may improve survival. Clinicians should pay attention to similar metastatic diseases to prevent misdiagnosis leading to missed treatment opportunities. CONCLUSION This report of the characteristics and successful management of a rare case of iris metastasis from ccRCC highlights the importance of a comprehensive medical history, histopathology, immunohistochemistry, and clinical manifestation for successful disease diagnosis.
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Affiliation(s)
- Tong-Tong Wang
- Department of Graduate School, Hebei Medical University, Shijiazhuang 050017, Hebei Province, China
- Department of Pathology, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Xiao-Yue Chen
- Department of Pathology, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Qiao-Yun Min
- Department of Pathology, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
- School of Basic Medicine, Hebei North University, Zhangjiakou 075000, Hebei Province, China
| | - Yi-Ze Han
- Department of Graduate School, Hebei Medical University, Shijiazhuang 050017, Hebei Province, China
| | - Huan-Fen Zhao
- Department of Pathology, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
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Liu T, Bai F, Yang L, Liu L, Xiao J, Liu X. Primary Tumour Type, Clinical Features, Treatment and Outcome of Patients with Iris Metastasis. Ocul Immunol Inflamm 2022; 30:1726-1732. [PMID: 34228589 DOI: 10.1080/09273948.2021.1939392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE To describe the primary tumour type, clinical features, treatment and outcome of patients with Iris metastasis. METHODS Retrospectively analyzed articles published from 1934 to 2019 in the PubMed database. RESULTS In total, 133 eyes of 125 patients with iris metastatic carcinoma were retrieved. The average age at metastasis diagnosis of the patients was 56 ± 15 years; 60 left eyes and 49 right eyes were involved. The most common primary tumors were lung carcinoma (42%) and breast carcinoma (15%). Approximately one-third of the patients were first diagnosed in the ophthalmology department before the primary tumor was detected. Twenty-two percent of iris metastases were discovered before and 33% were discovered after systemic metastasis. The most common complaints were blurred vision and pain. The clinical features included iris masses, neovascularization and keratic precipitates. 57 patients (64%, N = 90) had an elevated intraocular pressure. Local administration of radiation therapy or intraocular injections of anti-VEGF drugs relieved eye discomfort and controlled the high intraocular pressures. CONCLUSIONS Iris nodules with increased intraocular pressure and neovascularization may indicate iris metastasis. Lung cancer is the most common primary tumor.
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Affiliation(s)
- Tao Liu
- Ophthalmologic Center of the Second Hospital, Jilin University, Changchun, P.R. China
| | - Feng Bai
- Ophthalmologic Center of the Second Hospital, Jilin University, Changchun, P.R. China
| | - Li Yang
- Ophthalmologic Center of the Second Hospital, Jilin University, Changchun, P.R. China
| | - Li Liu
- Ophthalmologic Center of the Second Hospital, Jilin University, Changchun, P.R. China
| | - Jun Xiao
- Ophthalmologic Center of the Second Hospital, Jilin University, Changchun, P.R. China
| | - Xiaoli Liu
- Ophthalmologic Center of the Second Hospital, Jilin University, Changchun, P.R. China
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Wada K, Tsuda T, Hanada Y, Maeda Y, Mori K, Nishimura H. A Rare Case of Prostate Carcinoma Metastasis in the Orbital Apex. EAR, NOSE & THROAT JOURNAL 2020; 101:571-574. [PMID: 33215539 DOI: 10.1177/0145561320973783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Prostate cancer (PC) is prone to bone metastases, but very rarely it can spread to soft tissues. In the head and neck region, PC can metastasize to the orbital soft tissue, causing various symptoms such as vision loss. In this report, we describe the case of a 79-year-old man with PC metastasis in the orbital apex. He presented to an ophthalmologist at our hospital with progressively worsening vision in his left eye over 3 to 4 months. He complained of a drooping eyelid in the same eye; thus, intracranial disease was suspected. Closer inspection with head computed tomography revealed a space-occupying lesion from the orbit to the posterior ethmoid sinus, and he was referred to our department. He had a history of PC, and we performed endoscopic sinus surgery for the diagnosis of malignancy, including metastasis of PC. As a result, the mass was diagnosed as PC metastasis by pathological examination. The patient began androgen blockade therapy and 3 months postoperatively, magnetic resonance imaging revealed that the extraconal orbital mass had decreased significantly. It is important to determine the metastases of PC in the paranasal region when the patient has a preexisting medical history.
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Affiliation(s)
- Kento Wada
- Department of Otorhinolaryngology, National Hospital Organization Osaka National Hospital, Osaka City, Osaka, Japan
| | - Takeshi Tsuda
- Department of Otorhinolaryngology, National Hospital Organization Osaka National Hospital, Osaka City, Osaka, Japan.,Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan
| | - Yukiko Hanada
- Department of Otorhinolaryngology, National Hospital Organization Osaka National Hospital, Osaka City, Osaka, Japan
| | - Yohei Maeda
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan
| | - Kiyoshi Mori
- Department of Central Laboratory and Surgical Pathology, National Hospital Organization Osaka National Hospital, Osaka City, Osaka, Japan
| | - Hiroshi Nishimura
- Department of Otorhinolaryngology, National Hospital Organization Osaka National Hospital, Osaka City, Osaka, Japan
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Eye Symptoms in a Patient With Prostate Cancer. Clin Nucl Med 2020; 45:370-371. [PMID: 32149800 DOI: 10.1097/rlu.0000000000002982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A 66-year-old man with castration-resistant prostate cancer was evaluated with F-prostate-specific membrane antigen (PSMA) 1007 PET/CT, which revealed extensive PSMA-positive skeletal metastases in the skull, thorax, spine, pelvis, and extremities. He was then treated Lu-PSMA-617 therapy. Twenty-four-hour SPECT/CT revealed additional activity not seen with F-PSMA adjacent to his left eye. The lesion was biopsied after the first cycle due to pain. This activity was not visible on SPECT/CT after the second treatment cycle, and his eye pain has resolved.
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Bilateral Orbital Metastasis of Prostatic Adenocarcinoma. Urology 2016; 94:e3-4. [PMID: 27181244 DOI: 10.1016/j.urology.2016.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 04/27/2016] [Accepted: 05/03/2016] [Indexed: 11/20/2022]
Abstract
Despite the high incidence of prostate carcinoma, metastases of the uvea are very rare and bilateral localization is even more. We report here the case of a 77-year-old man diagnosed with a metastatic prostate carcinoma. Two months later, he presented a decreased vision in his right eye and blurred vision in the left eye relevant to metastatic lesion on his right iris and left choroidal metastasis. The urologist should evoke possibility of ocular metastasis in patients with prostate cancer presenting visual disorders.
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Kapur S, Xiao H. Extraconal Orbital Soft Tissue Metastasis Secondary to Prostate Cancer: An Unusual Presentation. World J Oncol 2014; 5:139-143. [PMID: 29147393 PMCID: PMC5649818 DOI: 10.14740/wjon807w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2014] [Indexed: 11/16/2022] Open
Abstract
Prostate cancer is mostly known to metastasize to the bony skeleton. Soft tissue metastasis involving visceral organs such as the liver, lung and brain are unusual and rare manifestations of this cancer. However, with better treatment modalities and increased survival, the incidence of these unusual presentations, seems to have risen in the last few years. Prostate cancer is rarely known to metastasize to the orbit. Although cases of bony metastasis involving the orbit have been reported, soft tissue metastasis involving the orbit is a very rare presentation. Most soft tissue metastasis to the orbit involves the uveal tract, with prostate cancer being the most common primary cancer to metastasize to the iris (uveal tract). Our paper highlights a case of extraconal orbital soft tissue metastasis secondary to prostate cancer, an extremely rare presentation. Patient was started on combined androgen blockade therapy. Three-month repeat MRI orbit showed that the extraconal orbital mass had decreased in size significantly. His clinical symptoms have resolved at the time of this report. To our knowledge, this is the first reported case of its kind.
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Affiliation(s)
- Sakshi Kapur
- Department of Internal Medicine, Overlook Medical Center, 99 Beauvoir Ave, Summit, New Jersey, 07902, USA
| | - Han Xiao
- Division of Medical Oncology, Memorial Sloan-Kettering Cancer Center Basking Ridge, 136 Mountain View Boulevard, Basking Ridge, New Jersey, 07920, USA
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Mutlu H, Akça Z, Büyükçelik A, Oztürk M, Taşdemir M, Kubilay Yazıcıoğlu A, Kaplan B, Uçar K. The MRI findings of iris metastasis in patients with breast cancer. Acta Inform Med 2013; 20:259-60. [PMID: 23378695 PMCID: PMC3558288 DOI: 10.5455/aim.2012.20.259-260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Accepted: 10/30/2012] [Indexed: 11/06/2022] Open
Abstract
Breast cancer and lung cancer are the most common tumors that metastasize to iris. The metastasis of iris was generally diagnosed on ophthalmologic examination. In this case, we reported iris metastasis of patients with adenocarcinoma of breast cancer and MRI findings. We report a case of a 51-year-old. She was diagnosed breast cancer two years ago. After adjuvant chemotherapy, radiotherapy and trastuzumab, she was admitted to hospital with the complaints of headache on February 2012. The magnetic resonance imaging (MRI ) revealed multiple brain metastasis. Whole brain radiotherapy and palliative chemotherapy were applied to the patients. In follow-up, on ophthalmological examination, there was a solid lesion on iris. The orbital MRI was performed and it revealed the thickness on iris of left eye. After diagnostic procedure final pathological rewiev reported that invasive ductal carcinom metastasis. Iris metastasis may be considered by MRI findings following: The thickness on iris and contrast enhanced lesion. This reason may be resulted that the fine niddle aspiration biopsy for diagnosis of iris metastasis is not need.
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Affiliation(s)
- Hasan Mutlu
- Department of Medical Oncology, Acıbadem Kayseri Hospital, Kayseri, Turkey
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