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Late orbital metastasis from colon cancer complicated by multiple tumors in the breast, lung, liver, and spine.

Authors
  • Makino, Kensaku1
  • Tsutsumi, Satoshi1
  • Takaki, Yuki1
  • Nonaka, Senshu1
  • Okura, Hidehiro1
  • Ishii, Hisato1
  • 1 Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan. , (Japan)
Type
Published Article
Journal
Radiology Case Reports
Publisher
Elsevier BV
Publication Date
Jan 01, 2022
Volume
17
Issue
1
Pages
5–12
Identifiers
DOI: 10.1016/j.radcr.2021.09.057
PMID: 34760033
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

A 69-year-old woman sustained progressive proptosis for 2 months. The patient had undergone surgery for resection of colon cancer 10 years prior, which was considered to have been completely cured 5 years prior. She was also aware of a hard mass in her left breast, but it had been left untreated. Furthermore, she experienced back pain for a month. Blood examination revealed an elevated level of serum carcinoembryonic antigen, at 17.4 ng/mL (< 5). Computed tomography (CT) revealed a tumor occupying the superolateral part of the right orbit, with intratumoral calcifications and destructive changes in the lateral orbital wall. On magnetic resonance imaging, it appeared as a heterogeneously enhancing, extraconal tumor, 44 mm × 31 mm in maximal dimension, extending into the middle fossa and the adjacent subcutaneous region. Fluorodeoxyglucose positron emission tomography/CT revealed abnormal accumulation in the left breast, T12 vertebra, liver, and lung, in addition to the orbital tumor. The patient underwent total tumor resection through a lateral orbitotomy. Histological examination of the tumor was highly suggestive of a metastatic colon cancer. Late metastasis should be assumed as a differential diagnosis that can be determined only through histological verification. © 2021 The Authors. Published by Elsevier Inc. on behalf of University of Washington.

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