A Metastatic Tumor of Ewing’s Sarcoma in the Orbit

Volume 1 - Issue 5

Dilan YILDIZ¹, Gamze MADEN¹*, Şeyma Gülcenur ÖZTURAN¹, Serap Yurttaşer Ocak¹, Mehmet Tayfur¹, Mehmet Egemen KARATA޲ and Mustafa Nuri ELÇİOĞLU¹

Received: September 14, 2018;   Published: September 21, 2018

DOI: 10.32474/TOOAJ.2018.01.000123

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Abstract

Aim: We aimed to present the patient with the metastasis of Ewing’s sarcoma in orbit because of being seen very rarely

Case: 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 (Figure 1). 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 (Figure 2). 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 (Figure 3).

Conclusion: In conclusion, in this case it is emphasized that orbital metastases should be considered in the differential diagnosis of patients with proptosis and periorbital edema and also it is important to question the story of the patient detailed so it’s possible to prevent the development of permanent pathologies if treatment is started rapidly.

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