RESUMO
Pharmacologic inhibition of tumor necrosis factor-alpha (TNF-α) has been used in the management of a variety of inflammatory conditions. Recently, reports on the development of sarcoid-like granulomatous disease at multiple systemic sites after treatment with TNF-α inhibitors have emerged, although, to the authors' knowledge, orbital manifestations of this problem have not been previously described. A 48-year-old woman who received injections of adalimumab for the treatment of psoriatic arthritis developed right-sided orbital pain and inflammation. Orbital biopsy of a focal lesion demonstrated sarcoid-like granulomatosis, and a workup for other causes of this problem was noncontributory. This report represents the first documented case of this phenomenon in the orbit, and possible mechanisms are discussed in this presentation. Given the expanding role of TNF-α inhibitors and the increased frequency of their use, clinicians should be aware of this possible side effect.
Assuntos
Adalimumab/efeitos adversos , Anti-Inflamatórios/efeitos adversos , Granuloma/induzido quimicamente , Doenças Orbitárias/induzido quimicamente , Sarcoidose/induzido quimicamente , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Administração Oral , Artrite Psoriásica/tratamento farmacológico , Quimioterapia Combinada , Dor Ocular/etiologia , Feminino , Glucocorticoides/uso terapêutico , Granuloma/diagnóstico , Granuloma/tratamento farmacológico , Humanos , Imunossupressores/efeitos adversos , Metotrexato/uso terapêutico , Pessoa de Meia-Idade , Doenças Orbitárias/diagnóstico , Doenças Orbitárias/tratamento farmacológico , Prednisona/administração & dosagem , Sarcoidose/diagnóstico , Sarcoidose/tratamento farmacológicoRESUMO
Synovial sarcomas are rare malignancies. Metastatic synovial sarcomas carry a particularly poor prognosis. While primary orbital lesions have been documented, the authors are aware of only one previous report of metastatic synovial sarcoma to the orbit. In this report, the second case of a metastatic synovial sarcoma to the orbit is described and the medical literature on this subject is reviewed.
Assuntos
Neoplasias Orbitárias/secundário , Sarcoma Sinovial/secundário , Neoplasias de Tecidos Moles/patologia , Adolescente , Antineoplásicos/uso terapêutico , Desoxicitidina/análogos & derivados , Desoxicitidina/uso terapêutico , Docetaxel , Evolução Fatal , Feminino , Humanos , Neoplasias Orbitárias/tratamento farmacológico , Neoplasias Orbitárias/radioterapia , Sarcoma Sinovial/tratamento farmacológico , Sarcoma Sinovial/radioterapia , Neoplasias de Tecidos Moles/terapia , Taxoides/uso terapêutico , GencitabinaAssuntos
Hiperplasia Angiolinfoide com Eosinofilia/etnologia , Negro ou Afro-Americano , Doenças do Aparelho Lacrimal/etnologia , Adulto , Hiperplasia Angiolinfoide com Eosinofilia/tratamento farmacológico , Hiperplasia Angiolinfoide com Eosinofilia/patologia , Ciclosporina/uso terapêutico , Quimioterapia Combinada , Humanos , Imunossupressores/uso terapêutico , Doenças do Aparelho Lacrimal/tratamento farmacológico , Doenças do Aparelho Lacrimal/patologia , Masculino , Prednisona/uso terapêutico , Tomografia Computadorizada por Raios XRESUMO
PURPOSE: To report a case of spermatic cord leiomyosarcoma metastatic to the orbit. DESIGN: Case report. METHODS: A 78-year-old man presented with progressive redness, proptosis, and decreasing vision of the left eye of 3 weeks' duration. Computed tomography revealed an intraconal mass (1.5 x 2 cm) inferior to and displacing the left optic nerve. RESULTS: A left lateral orbitotomy was performed, and a well-demarcated mass was removed from the surrounding tissue. A follow-up computed tomography of the chest and abdomen was consistent with metastatic disease to the lungs and liver. CONCLUSIONS: Spermatic cord leiomyosarcoma is a rare cause of metastatic lesions to the orbit.
