Iris, ciliary body and choroid metastasis from salivary duct carcinoma of parotid gland: Case report

IF 2.8 3区医学 Q1 OPHTHALMOLOGY Acta Ophthalmologica Pub Date : 2025-01-19 DOI:10.1111/aos.17335

Vasco Lobo, Bernardo Monteiro, Rafael Whitfield, Cecília Alvim, Filomena Pinto

{"title":"Iris, ciliary body and choroid metastasis from salivary duct carcinoma of parotid gland: Case report","authors":"Vasco Lobo, Bernardo Monteiro, Rafael Whitfield, Cecília Alvim, Filomena Pinto","doi":"10.1111/aos.17335","DOIUrl":null,"url":null,"abstract":"<div>\n \n <section>\n \n <p><b>Aims/Purpose:</b> Report a rare case of salivary duct carcinoma (SDC) of the left parotid gland metastatic to the iris, ciliary body and choroid.</p>\n \n <p><b>Methods:</b> Data collection from clinical records.</p>\n \n <p><b>Results:</b> A 70-year-old woman with a history of stage IV SDC of the left parotid (pT2 cNx cM1) diagnosed in November 2020, treated with palliative chemotherapy with cisplatin since October 2021, presented to Ophthalmology department in Hospital de Santa Maria, Lisbon, Portugal in November 2021 due to a solid lesion in the anterior chamber and progressive declining vision of the left eye. Ultrasound biomicroscopy showed a 6.7x12.0x4.7mm cupuliform mass in the iris, with high reflectivity and heterogeneous internal structure, involving the ciliary body and displacing posteriorly the intraocular lens. Posterior segment ultrasound revealed a solid cupuliform lesion of the ocular wall, approximately 3 mm thick, with high reflectivity and a heterogeneous structure. The ultrasound characteristics were consistent with secondary intraocular lesion of the iris, ciliary body and choroid and orbital MRI supported this diagnosis. In December 2021, due to global systemic progression after three cycles of cisplatin, the patient was switched to 9 cycles of doxorubicin+cyclophosphamide, with apparent stabilization of the systemic disease. In September 2022, there was a significant reduction in the size of the iris metastasis, even though the posterior segment ultrasound demonstrated progression of the intraocular disease, now with multifocal choroidal metastasis in both eyes, associated with exudative detachment of the retina in the right eye. Due to multiple cerebral metastasis, the patient underwent holocranial radiotherapy 30 Gy/10 fractions, with ophthalmological findings being unchanged in October 2022. She underwent two more cycles of paclitaxel, which was suspended due to clinical deterioration. The patient died in December 2022, with a survival of 25 months (13 months since diagnosis of intraocular metastases).</p>\n \n <p><b>Conclusions:</b> The case reports a rare presentation of metastatic SDC to the eye.</p>\n </section>\n </div>","PeriodicalId":6915,"journal":{"name":"Acta Ophthalmologica","volume":"103 S284","pages":""},"PeriodicalIF":2.8000,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/10.1111/aos.17335","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Ophthalmologica","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/aos.17335","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Aims/Purpose: Report a rare case of salivary duct carcinoma (SDC) of the left parotid gland metastatic to the iris, ciliary body and choroid.

Methods: Data collection from clinical records.

Results: A 70-year-old woman with a history of stage IV SDC of the left parotid (pT2 cNx cM1) diagnosed in November 2020, treated with palliative chemotherapy with cisplatin since October 2021, presented to Ophthalmology department in Hospital de Santa Maria, Lisbon, Portugal in November 2021 due to a solid lesion in the anterior chamber and progressive declining vision of the left eye. Ultrasound biomicroscopy showed a 6.7x12.0x4.7mm cupuliform mass in the iris, with high reflectivity and heterogeneous internal structure, involving the ciliary body and displacing posteriorly the intraocular lens. Posterior segment ultrasound revealed a solid cupuliform lesion of the ocular wall, approximately 3 mm thick, with high reflectivity and a heterogeneous structure. The ultrasound characteristics were consistent with secondary intraocular lesion of the iris, ciliary body and choroid and orbital MRI supported this diagnosis. In December 2021, due to global systemic progression after three cycles of cisplatin, the patient was switched to 9 cycles of doxorubicin+cyclophosphamide, with apparent stabilization of the systemic disease. In September 2022, there was a significant reduction in the size of the iris metastasis, even though the posterior segment ultrasound demonstrated progression of the intraocular disease, now with multifocal choroidal metastasis in both eyes, associated with exudative detachment of the retina in the right eye. Due to multiple cerebral metastasis, the patient underwent holocranial radiotherapy 30 Gy/10 fractions, with ophthalmological findings being unchanged in October 2022. She underwent two more cycles of paclitaxel, which was suspended due to clinical deterioration. The patient died in December 2022, with a survival of 25 months (13 months since diagnosis of intraocular metastases).

Conclusions: The case reports a rare presentation of metastatic SDC to the eye.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

腮腺涎管癌的虹膜、睫状体及脉络膜转移1例

目的：报告1例罕见的左侧腮腺涎腺导管癌（SDC）转移至虹膜、睫状体及脉络膜。方法：收集临床资料。结果：一名70岁女性，于2020年11月确诊为左侧腮腺IV期SDC （pT2 cNx cM1）病史，自2021年10月起接受顺铂姑息性化疗，因前房实性病变，左眼视力进行性下降，于2021年11月在葡萄牙里斯本圣玛丽亚医院眼科就诊。超声生物显微镜检查示：虹膜内有6.7x12.0x4.7mm的杯状肿块，反射率高，内部结构不均匀，累及睫状体，后移人工晶状体。后段超声显示眼壁呈实性杯状病变，厚度约3mm，反射率高，结构不均匀。超声表现与继发性眼内虹膜、睫状体、脉络膜病变一致，眼眶MRI支持此诊断。2021年12月，由于顺铂治疗3个周期后全身性进展，患者切换到阿霉素+环磷酰胺治疗9个周期，全身性疾病明显稳定。2022年9月，虹膜转移的大小显著减小，尽管后段超声显示眼内疾病进展，现在双眼多灶脉络膜转移，右眼伴有渗出性视网膜脱离。患者因多发脑转移，于2022年10月行全颅放疗30 Gy/10次，眼科检查无变化。她又接受了两个周期的紫杉醇治疗，因临床恶化而暂停。该患者于2022年12月死亡，存活时间为25个月（自诊断为眼内转移后13个月）。结论：该病例报告了一种罕见的眼部转移性SDC。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Acta Ophthalmologica 医学-眼科学

CiteScore

7.60

自引率

5.90%

发文量

433

审稿时长

6 months

期刊介绍： Acta Ophthalmologica is published on behalf of the Acta Ophthalmologica Scandinavica Foundation and is the official scientific publication of the following societies: The Danish Ophthalmological Society, The Finnish Ophthalmological Society, The Icelandic Ophthalmological Society, The Norwegian Ophthalmological Society and The Swedish Ophthalmological Society, and also the European Association for Vision and Eye Research (EVER). Acta Ophthalmologica publishes clinical and experimental original articles, reviews, editorials, educational photo essays (Diagnosis and Therapy in Ophthalmology), case reports and case series, letters to the editor and doctoral theses.