Rare Orbital Metastasis Originating from Ampullary Adenocarcinoma

Orbital metastasis from ampullary carcinoma is rare, with no previously reported cases. We report the case of a 60-year-old man who complained of a right-sided headache, blurred vision, progressive proptosis, ptosis, and right eye pain for 3 months. His past medical history included an ampullary ade...

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Bibliographic Details
Published in:Medicina (Kaunas, Lithuania) Lithuania), 2021-11, Vol.57 (11), p.1238
Main Authors: Tsai, Yung-En, Chien, Ke-Hung, Li, Yao-Feng, Lai, Shiue-Wei
Format: Article
Language:English
Subjects:
Adenocarcinoma - diagnostic imaging
Adenocarcinoma - secondary
Ampulla of Vater - diagnostic imaging
Ampulla of Vater - pathology
ampullary carcinoma
Biopsy
Cancer
Case Report
Chemotherapy
Common Bile Duct Neoplasms - diagnostic imaging
Common Bile Duct Neoplasms - pathology
Cytokeratin
Eye diseases
Eye movements
Humans
Hypoglycemia
Informed consent
Insulin
Male
Medical prognosis
Metastasis
Middle Aged
orbital metastasis
Orbital Neoplasms - secondary
orbital tumor
Pancreatic Neoplasms
Pancreaticoduodenectomy
Patients
Peptides
Prostate
Tomography
Tumors
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Summary:Orbital metastasis from ampullary carcinoma is rare, with no previously reported cases. We report the case of a 60-year-old man who complained of a right-sided headache, blurred vision, progressive proptosis, ptosis, and right eye pain for 3 months. His past medical history included an ampullary adenocarcinoma stage IIIA treated via the Whipple procedure and adjuvant chemoradiotherapy 1 year ago. However, he was lost to follow-up. Computed tomography of the orbit showed a soft tissue lesion in the right orbital fossa measuring 3.3 × 2 × 2 cm. An orbital mass biopsy demonstrated an intestinal-type adenocarcinoma that tested positive for cytokeratins 7 and 20 and CDX2 on immunohistochemical staining. The pathologic diagnosis was metastatic adenocarcinoma from the ampulla of Vater. Despite oncological treatment, the patient's illness progressed. He received palliative treatment and died 1 month later. We presented a rare case of orbital metastasis from ampullary adenocarcinoma. This should be considered in the differential diagnosis of patients with a history of ampullary adenocarcinoma who present with symptoms referring to the relevant locations.
ISSN:1648-9144
1010-660X
1648-9144
DOI:10.3390/medicina57111238