Metastatic involvement of the orbital due to bladder carcinoma simulating periorbital cellulitis: case report
DOI:
https://doi.org/10.48193/revistamexicanadeurologa.v82i5.902Keywords:
Bladder cancer, carcinoma in situ, metastasis, urothelial tumors, orbital cellulitisAbstract
Description of the clinical case: A 67-year-old man with history of radical cystectomy due to a muscle-invasive bladder tumor presented with an acute erythema and swelling in the left periorbital region accompanied by tenderness and decreased ocular motility. Initially, a periorbital cellulitis was suspected and empirical antibiotics treatment with initiated. As there was no improvement with the antibiotic regimen, it was decided to biopsy the lesion. The biopsy results were consistent with metastasis of bladder carcinoma.
Relevance: Bladder carcinoma represents one of the most common urological tumors, affecting predominantly males. The most frequent sites of metastasis are the lymph nodes, lungs, and bones; metastatic involvement of the orbit by bladder carcinoma is rare.
Clinical implications: Although metastatic involvement of the orbit by urothelial tumors is very rare, it is important to know the characteristics of the lesion in order to make a timely diagnosis and thus provide adequate treatment.
Conclusion: In patients with a history of bladder cancer who present periorbital cellulitis without improvement of symptoms despite adequate antibiotic treatment, orbital involvement due to bladder tumor metastasis should be suspected.
References
Antoni S, Ferlay J, Soerjomataram I, Znaor A, Jemal A, Bray F. Bladder Cancer Incidence and Mortality: A Global Overview and Recent Trends. Eur Urol. 2017 Jan;71(1):96–108. doi: https://doi.org/10.1016/j.eururo.2016.06.010
Burger M, Catto JWF, Dalbagni G, Grossman HB, Herr H, Karakiewicz P, et al. Epidemiology and risk factors of urothelial bladder cancer. Eur Urol. 2013 Feb;63(2):234–41. doi: https://doi.org/10.1016/j.eururo.2012.07.033
Shinagare AB, Ramaiya NH, Jagannathan JP, Fennessy FM, Taplin M-E, Van den Abbeele AD. Metastatic pattern of bladder cancer: correlation with the characteristics of the primary tumor. AJR Am J Roentgenol. 2011 Jan;196(1):117–22. doi: https://doi.org/10.2214/ajr.10.5036
Al-Zalabani AH, Stewart KFJ, Wesselius A, Schols AMWJ, Zeegers MP. Modifiable risk factors for the prevention of bladder cancer: a systematic review of meta-analyses. Eur J Epidemiol. 2016 Sep;31(9):811–51. doi: https://doi.org/10.1007/s10654-016-0138-6
Sylvester RJ, van der Meijden A, Witjes JA, Jakse G, Nonomura N, Cheng C, et al. High-grade Ta urothelial carcinoma and carcinoma in situ of the bladder. Urology. 2005 Dec;66(6 Suppl 1):90–107. doi: https://doi.org/10.1016/j.urology.2005.06.135
Bonavolontà G, Strianese D, Grassi P, Comune C, Tranfa F, Uccello G, et al. An analysis of 2,480 space-occupying lesions of the orbit from 1976 to 2011. Ophthalmic Plast Reconstr Surg. 2013 Apr;29(2):79–86. doi: https://doi.org/10.1097/iop.0b013e31827a7622
Shields JA, Shields CL, Scartozzi R. Survey of 1264 patients with orbital tumors and simulating lesions: The 2002 Montgomery Lecture, part 1. Ophthalmology. 2004 May;111(5):997–1008. doi: https://doi.org/10.1016/j.ophtha.2003.01.002
Ghali A, Bahr T, Sherwani A, Nashawi M, Wilde D, Woolf S. Acute inflammatory presentation of orbital metastasis from urothelial carcinoma: a case report. Orbit. 2022 Dec;41(6):786–90. doi: https://doi.org/10.1080/01676830.2021.1933082
Fierlbeck I, Helmbold P. Bilaterale periorbitale Metastasen eines Urothelkarzinoms der Harnblase. Hautarzt. 2011 Apr 1;62(4):287–9. [accessed 16 Nov 2022] Available from: https://doi.org/10.1007/s00105-010-2022-8
Allen RC. Orbital Metastases: When to Suspect? When to biopsy? Middle East Afr J Ophthalmol. 2018;25(2):60–4. [accessed 16 Nov 2022] Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6071345/
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