A Case of Endonasal Endoscopic Surgery for Intraorbital Metastasis of Gastric Ring Cell Carcinoma

Author:

Tsuruta Yukinori12,Maeda Yohei1ORCID,Kitaguchi Yoshiyuki3,Hayama Masaki1,Nojima Satoshi4,Tsuda Takeshi1,Takeda Kazuya1,Nakatani Ayaka1,Obata Sho1,Morii Eiichi4,Inohara Hidenori1

Affiliation:

1. Department of Otorhinolaryngology–Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan

2. Department of Otorhinolaryngology, Ikeda City Hospital, Ikeda City, Osaka, Japan

3. Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan

4. Department of Pathology, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan

Abstract

Gastric signet ring cell carcinoma has well-known metastatic features, including peritoneal dissemination and carcinomatous lymphangitis of the lung, but no intraorbital metastases were reported previously. A woman in her 60s developed left eye pain, sudden vision loss, and headache 12 years after gastric cancer treatment. Symptoms did not improve despite steroid pulses. Craniotomy showed no malignant findings. The patient was referred to our department for symptomatic relief and biopsy due to the lack of a definitive diagnosis and no improvement in her ocular pain. Endonasal endoscopic surgery was performed for diagnostic purposes and to relieve symptoms through orbital decompression. Preoperative computed tomography examination revealed a tumor at the left medial orbit, extending to the orbital apex. Orbital decompression through the open left medial orbital wall was performed with biopsy of the intraorbital tumor. Pathological findings were consistent with metastatic signet ring cell carcinoma. Pain and subjective improvement of visual acuity were noted the day after surgery. Twelve months postoperatively, diplopia remains, but there has been no worsening of symptoms.

Publisher

SAGE Publications

Subject

Otorhinolaryngology

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1. Prediction Model of Ocular Metastases in Gastric Adenocarcinoma: Machine Learning-Based Development and Interpretation Study;Technology in Cancer Research & Treatment;2024-01

2. Metastatic gastric carcinoma to the eyelids masquerading as a chalazion: A case report;American Journal of Ophthalmology Case Reports;2023-03

3. Periorbital Skull Base Neoplasms;Orbital Apex and Periorbital Skull Base Diseases;2023

4. Diplopia Secondary to Gastric Adenocarcinoma Metastasis to the Superior Oblique Muscle;Ear, Nose & Throat Journal;2022-12-06

5. 内視鏡下鼻副鼻腔手術の適応拡大 眼窩;Nippon Jibiinkoka Gakkai Kaiho;2021-06-20

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