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Alveolar Rhabdomyosarcoma of the foot metastasizing to the Iris: report of a rare case.

Fabian ID, Hildebrand GD, Wilson S, Foord T, Sagoo MS - BMC Cancer (2016)

Bottom Line: However, anterior uveitis and raised intraocular pressure developed and she was referred to our service for further management.The patient was treated with external beam radiotherapy to the globe and orbit, but died 2 months after treatment completion.We report that secondary spread to the iris can also occur, in this case as the first sign of widely disseminated systemic relapse.

View Article: PubMed Central - PubMed

Affiliation: Ocular Oncology Service, Moorfields Eye Hospital, 162 City Road, London, EC1V 2PD, UK. didifabian@gmail.com.

ABSTRACT

Background: Intraocular iris rhabdomyosarcoma is extremely rare, and in the 3 cases reported to date occurred as the primary site of tumour growth. We report a case of rhabdomyosarcoma of the foot metastasizing to the iris.

Case presentation: An 18-year-old white female was referred to the London Ocular Oncology Service for management of a metastatic rhabdomyosarcomatous deposit in the iris, a metastasis from alveolar rhabdomyosarcoma of the foot. She was diagnosed nearly 2 years earlier with the primary sarcoma with extensive systemic spread and treated by resection of the foot lesion and chemotherapy, and achieved a partial remission. The left iris deposit was noted while she was receiving systemic chemotherapy, heralding a relapse. However, anterior uveitis and raised intraocular pressure developed and she was referred to our service for further management. A left iris secondary rhabdomyosarcoma deposit was noticed and in addition a lacrimal gland mass, as indicated by ultrasound B scan of the eye and orbit. The patient was treated with external beam radiotherapy to the globe and orbit, but died 2 months after treatment completion.

Conclusion: Rhabdomyosarcoma of the iris is very rare and was previously documented only as a primary malignancy in this location. We report that secondary spread to the iris can also occur, in this case as the first sign of widely disseminated systemic relapse.

No MeSH data available.


Related in: MedlinePlus

Left eye iris mass at presentation (a), resolved after initial systemic chemotherapy (b). Ocular tumour relapse (arrow) and neovascularization of the iris (arrowhead) (c), demonstrated also on B mode ultrasound scan (d)
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Fig1: Left eye iris mass at presentation (a), resolved after initial systemic chemotherapy (b). Ocular tumour relapse (arrow) and neovascularization of the iris (arrowhead) (c), demonstrated also on B mode ultrasound scan (d)

Mentions: Fourteen months after diagnosis of the metastatic RMS she noticed a change in the left iris colour. Examination done at the Oxford Eye Hospital indicated an iris mass (Fig. 1a), and on PET scan, extensive systemic relapse was detected, including uptake of the primary foot site, pulmonary nodules as well as the left iris. Vincristine, irinotecan and temozolomide (VIT) were started, to control the recurrent disease, including the iris metastasis, which showed good response (Fig. 1b). A subsequent on – treatment relapse occurred after 6 cycles of VIT (primary site, lungs and musculoskeletal). Palliative oral etoposide was commenced 5 months after first intraocular involvement, keeping the disease under relative control.Fig. 1


Alveolar Rhabdomyosarcoma of the foot metastasizing to the Iris: report of a rare case.

Fabian ID, Hildebrand GD, Wilson S, Foord T, Sagoo MS - BMC Cancer (2016)

Left eye iris mass at presentation (a), resolved after initial systemic chemotherapy (b). Ocular tumour relapse (arrow) and neovascularization of the iris (arrowhead) (c), demonstrated also on B mode ultrasound scan (d)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4940711&req=5

Fig1: Left eye iris mass at presentation (a), resolved after initial systemic chemotherapy (b). Ocular tumour relapse (arrow) and neovascularization of the iris (arrowhead) (c), demonstrated also on B mode ultrasound scan (d)
Mentions: Fourteen months after diagnosis of the metastatic RMS she noticed a change in the left iris colour. Examination done at the Oxford Eye Hospital indicated an iris mass (Fig. 1a), and on PET scan, extensive systemic relapse was detected, including uptake of the primary foot site, pulmonary nodules as well as the left iris. Vincristine, irinotecan and temozolomide (VIT) were started, to control the recurrent disease, including the iris metastasis, which showed good response (Fig. 1b). A subsequent on – treatment relapse occurred after 6 cycles of VIT (primary site, lungs and musculoskeletal). Palliative oral etoposide was commenced 5 months after first intraocular involvement, keeping the disease under relative control.Fig. 1

Bottom Line: However, anterior uveitis and raised intraocular pressure developed and she was referred to our service for further management.The patient was treated with external beam radiotherapy to the globe and orbit, but died 2 months after treatment completion.We report that secondary spread to the iris can also occur, in this case as the first sign of widely disseminated systemic relapse.

View Article: PubMed Central - PubMed

Affiliation: Ocular Oncology Service, Moorfields Eye Hospital, 162 City Road, London, EC1V 2PD, UK. didifabian@gmail.com.

ABSTRACT

Background: Intraocular iris rhabdomyosarcoma is extremely rare, and in the 3 cases reported to date occurred as the primary site of tumour growth. We report a case of rhabdomyosarcoma of the foot metastasizing to the iris.

Case presentation: An 18-year-old white female was referred to the London Ocular Oncology Service for management of a metastatic rhabdomyosarcomatous deposit in the iris, a metastasis from alveolar rhabdomyosarcoma of the foot. She was diagnosed nearly 2 years earlier with the primary sarcoma with extensive systemic spread and treated by resection of the foot lesion and chemotherapy, and achieved a partial remission. The left iris deposit was noted while she was receiving systemic chemotherapy, heralding a relapse. However, anterior uveitis and raised intraocular pressure developed and she was referred to our service for further management. A left iris secondary rhabdomyosarcoma deposit was noticed and in addition a lacrimal gland mass, as indicated by ultrasound B scan of the eye and orbit. The patient was treated with external beam radiotherapy to the globe and orbit, but died 2 months after treatment completion.

Conclusion: Rhabdomyosarcoma of the iris is very rare and was previously documented only as a primary malignancy in this location. We report that secondary spread to the iris can also occur, in this case as the first sign of widely disseminated systemic relapse.

No MeSH data available.


Related in: MedlinePlus