Abstract
Orbital apex metastasis from adenoid cystic carcinoma (ACC) is rare. We present a patient with known metastatic ACC presented with a rapidly declining vision with visual acuity oculus dexter (OD) equal to counting fingers at two feet. On imaging, she was found to have a right orbital apex tumor causing compressive optic neuropathy. She received the intensity modulated radiation therapy (IMRT). After completion of the therapy, she had regained essentially a full vision with visual acuity OD of 20/30 without corrective lenses. The treatment rationale and pertinent literature are discussed in this article.
Highlights
BackgroundVisual loss due to extraocular orbital metastases is a relatively uncommon [1] and devastating complication of malignancy
We report the case of a 58-year-old female with the clinical history of cavernous sinus and right temporal lobe metastases, who presented with acute right visual loss due to compressive optic neuropathy
The patient with a known history of adenoid cystic carcinoma (ACC) metastases of the cavernous sinus and right temporal region presented with an ACC metastasis to the right orbital apex causing compressive optic neuropathy
Summary
Visual loss due to extraocular orbital metastases is a relatively uncommon [1] and devastating complication of malignancy. We report the case of a 58-year-old female with the clinical history of cavernous sinus and right temporal lobe metastases, who presented with acute right visual loss due to compressive optic neuropathy. She received radiotherapy with subsequent recovery of vision. The new area was followed by serial MRIs, which showed slow progression, evolving into two adjacent areas of enhancement These two new areas were treated with the hypo-fractionated radiotherapy on Cyberknife® receiving 4000 cGy in 10 fractions of 400 cGy per fraction (Figure 2), completed in October 2015.
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