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Ann Quan, Sona Shah, Kara Marie Cavuoto, M.D., Swarup S. Swaminathan, Armando Garcia, Thomas E Johnson, David T Tse, Wendy Lee, J. William Harbour, Sander Dubovy; Metastatic Lesions to the Eye and Orbit: A 15-year Retrospective Review. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3583.
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The prognosis of metastatic lesions to the eye and orbit is typically poor, with a survival time of approximately 5-10 years following diagnosis. As the prevalence of metastases to the eye and orbit has risen over the past 30 years, it is increasingly important for clinicians to be aware of the clinicopathologic features.
Retrospective review of medical charts and pathology records of patients with orbital and ocular metastases over a span of fifteen years (2004-2018) at the Bascom Palmer Eye Institute and Florida Lions Eye Bank was conducted. Data regarding the patient’s age, sex, presenting signs and symptoms, and clinical and histopathologic outcomes were analyzed.
A total of 35 patients with ocular metastases were identified, of which 25 were female (71.4%). The most common presenting symptoms were double vision (27.8%) and eyelid swelling (27.8%). Overall, the most frequent primary tumor was breast carcinoma (51.4%), while the other primary sites included lung (14.3%), cutaneous melanoma (8.6%), gastrointestinal tract (5.7%), prostate (5.7%), renal cell carcinoma (2.8%), and unknown origin (11.4%). The most common ocular site of metastases was the orbit (60%). The other anatomical sites affected included the choroid in three cases (11.1%), the vitreous in three cases (8.6%), and the medial rectus in two cases (5.7%), in addition to one case (2.8%) each in the inferior rectus, eyelid, iris, lacrimal gland, retina, and conjunctiva. With regard to the 18 cases of breast carcinoma, 17 patients were female (94.4%). The majority of breast cancer metastases were to the orbit (61.1%). Of note, all three cases of metastasis to the rectus muscles originated from breast carcinoma.
The orbit was the most common site for metastasis both overall (60%), as well as for the most common primary tumor, breast carcinoma (61.1%). Understanding the prevalence and clinicopathologic features of metastases helps guide early diagnosis and appropriate intervention.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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