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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two patients with previously diagnosed pheochromocytoma presented with facial pain and ptosis. Imaging revealed orbital lesions. Both patients were referred for surgical evaluation of the orbital mass. Surgical excision was performed for both. Pathology confirmed metastatic pheochromocytoma. Pheochromocytomas commonly metastasize to bone, liver, and other tissues. Five cases of metastasis to orbital bone have been previously described. These 2 cases are unique in that the metastases were not hormonally active, presented soon after initial diagnosis, and were treated palliatively with surgical excision. Previous treatment of orbital bony metastasis used radiotherapy. These cases demonstrate that surgical resection is a viable treatment option in these situations. Orbital metastasis of pheochromocytomas should be considered with the appropriate clinical presentation. These are the first documented cases of intraorbital metastasis, separate from the bony walls. Previously, orbital bony wall metastases were treated with radiation. Surgical excision is a viable option for treatment of such metastases.Orbital involvement should be considered in patients with systemic disease presenting with new ocular findings.
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PMID:Orbital Pheochromocytoma Metastasis in 2 Patients With Known Pheochromocytoma. 3159 45

Purpose: Due to improved survival durations and enhanced surveillance modalities, metastases of systemic malignancies to the orbit are increasing. This review is intended to discuss the epidemiologic, clinical, and management features of orbital metastases.Methods: A literature search for relevant publications on the topic was performed via PubMed, and the appropriate data were extracted from these manuscripts.Results: While rare, metastases to the orbit are regularly encountered in clinical practice. The overwhelming majority of these lesions present in adult patients, and metastatic disease may emerge several years after the diagnosis of the initial cancer. Subjectively, these lesions tend to present with complaints of diplopia, blurred vision, and pain, and objective signs tended to include vision loss, limitation of extraocular motility, proptosis, the presence of a palpable mass, and ptosis. Different studies reported a variety of primary tumors, although breast and lung malignancies were generally among the most common. A sizeable portion of patients may not have a known primary malignancy. After detection, survival rates are generally short, and metastatic disease suggests a worrisome prognosis. Radiation therapy may alleviate symptoms.Conclusions: Metastases of systemic disease present with specific subjective, clinical, and radiographic features. Furthermore, these lesions may present years after an initial diagnosis. Clinicians should be aware of the implications of this malady on patient survival and must consider interventions to improve quality of life.
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PMID:Metastases of systemic malignancies to the orbit: a major review. 3234 May 4

A 32-year-old otherwise healthy man presented with acute-onset bilateral blepharoptosis of 6 days' duration. On examination, he had severe ptosis bilaterally and mildly restricted abduction in the left eye. Brain magnetic resonance imaging showed a 10-mm-diameter lesion in the dorsal midbrain. The ptosis resolved spontaneously within two weeks. Systemic investigation did not uncover any aetiological factor. During 70 months' follow-up, neither any systemic disease nor ptosis relapse developed. Isolated nuclear midbrain ptosis has been previously reported in a few patients and these had neoplastic or inflammatory causes. In this patient, spontaneous resolution of the nuclear ptosis within weeks suggested that the underlying cause might be isolated ischaemic damage to the central caudal nucleus.
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PMID:Isolated and Transient Nuclear Midbrain Blepharoptosis in a Young and Healthy Adult. 3239 59


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