A Metastatic Tumor of Ewing’s Sarcoma in the Orbit by Gamze MADEN in TOOAJ- Lupine Publishers
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 periobital edema, proptosis and ptosis were present, and
the eye movements were restricted in all directions. There was a chemosis in
the right eye in the slit lamp examination and a slight deletion of the nasal
borders of the bilateral optic 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.
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 .
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