A Metastatic Tumor of Ewing’s Sarcoma in the Orbit by Gamze Maden in Trends in Ophthalmology Open Access Journal (TOOAJ)- Lupine Publishers
Aim: We aimed to
present the patient with the metastasis of Ewing’s sarcoma in orbit because of
being seen very rarely
Case: A 16-year-old male patient was
admitted to our clinic in June 2017 with a complaint of swelling in the right
eye for 2 days. In the examination, the best corrected vision acuity (BCVA) was
0,8 for the right eye and 0,9 for the left eye by Snellen. Right periobitaledema, proptosis and ptosis were present, and the eye movements were restricted
in all directions (Figure 1). There was a chemosis in the right eye in the slit
lamp examination and a slight deletion of the nasal borders of the bilateraloptic disc in the fundus examination. When the story of the patient was
questioned, we learned that he was treated with a diagnosis of Ewing’s sarcoma
in the left fibula 1 year ago and was diagnosed as urgent because of a
metastatic tumor causes the medulla spinalis compression which was found in the
lumbar region 1 week before. The massive lesion on the posterior wall of the
right orbit was detected in the orbital tomography, which made us think
metastasis of the Ewing’s sarcoma primarily for the differential diagnosis and
the patient was directed to the Department of Pediatric Oncology (Figure 2).
Upon observation of multiple bone involvement in the Positron Emission
Tomography, the patient was initiated a 5-day Iphosphamide + Carboplastin +
Etoposide systemic chemotherapy protocol. On day 2, a dramatic regression was
observed in the patient’s symptoms. At 1-week follow-up, the BCVA was bilateral
1.0, the eye movements were normal in all directions, the slit-lamp and fundus
findings and the intraocular pressure were normal.
Conclusion: In
conclusion, in this case it is emphasized that orbital metastases should be
considered in the differential diagnosis of patients with proptosis and
periorbital edema and also it is important to question the story of the patient
detailed so it’s possible to prevent the development of permanent pathologies
if treatment is started rapidly.
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