asensio-sanchez and cano-suarez clin case rep 21 :2 r ......asensio-sanchez and cano-suarez clin...

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Asensio-Sanchez and Cano-Suarez. J Clin Case Rep 2015, 5:2 DOI: 10.4172/2165-7920.1000i104 Volume 5 • Issue 2 • 1000i104 J Clin Case Rep ISSN: 2165-7920 JCCR, an open access journal Open Access Clinical Image Orbital Invasion in Nasopharyngeal Carcinoma Victor Manuel Asensio-Sanchez* and Magnolia Cano-Suarez Department of Ophthalmology, University Clinic Hospital, Valladolid, Spain *Corresponding author: Victor Manuel Asensio-Sanchez, Department of Oph- thalmology, University Clinic Hospital, Valladolid, Spain. Tel: 34-983377952; E- mail: [email protected] Received February 23, 2015; Accepted February 25, 2015; Published February 27, 2015 Citation: Asensio-Sanchez VM, Cano-Suarez M (2015) Orbital Invasion in Nasopharyngeal Carcinoma. J Clin Case Rep 5: i104. doi:10.4172/2165- 7920.1000i104 Copyright: © 2015 Asensio-Sanchez VM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Keywords: Nasopharyngeal carcinoma; Regaud pattern; Proptosis Clinical Image A 46 year old man was referred for a 3 weeks history of non- painful proptosis of the leſt eye. Physical examination revealed a tumor involving the orbital region (Figure 1). Orbital computed tomography imaging showed neoplastic expansive mass spread to the ethmoidal cells (Figure 2). Low-power microscopic examination of the orbital mass showed atypical cells with ovoid vesicular nuclei and prominent nucleoli, with inflammatory infiltrate composed of some eosinophils and lymphocytes. ese findings were consistent with the Regaud pattern of undifferentiated nasopharyngeal carcinoma (NC). e tumor showed abundantly expressed Epstein-Barr Virus (EBV) positivity by EBER in-situ hybridization (Figure 3). Although the pathogenesis of the nasopharyngeal carcinoma is not yet clear, it has been suggested that several factors appear: the EBV infection, environmental and genetic factors which are of major importance for the carcinogenesis. Direct orbital invasion is rare in NC. Inferior orbital fissure and the Abstract A 46 year old man presented with proptosis of the left eye. Extensive explorations revealed undifferentiated nasopharyngeal carcinoma. Figure 1: Figure 3: Figure 2: Figure 4: pterygopalatine fossa are the most common routes of invasion, followed by invasion via the ethmoid sinus. Aſter the patient was treated with radiotherapy and chemotherapy, the mass regress (Figure 4). ere were no signs of recurrence aſter 12 months of follow-up. Journal of Clinical Case Reports J o u r n a l o f C li n i c a l C a s e R e p o r t s ISSN: 2165-7920

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Page 1: Asensio-Sanchez and Cano-Suarez Clin Case Rep 21 :2 R ......Asensio-Sanchez and Cano-Suarez Clin Case Rep 21 :2 ¢ 141221-21i14 Clin Case Rep Volue ssue 2 1i14 SS: 21-2 CCR an open

Asensio-Sanchez and Cano-Suarez. J Clin Case Rep 2015, 5:2 DOI: 10.4172/2165-7920.1000i104

Volume 5 • Issue 2 • 1000i104J Clin Case RepISSN: 2165-7920 JCCR, an open access journal

Open AccessClinical Image

Orbital Invasion in Nasopharyngeal CarcinomaVictor Manuel Asensio-Sanchez* and Magnolia Cano-Suarez Department of Ophthalmology, University Clinic Hospital, Valladolid, Spain

*Corresponding author: Victor Manuel Asensio-Sanchez, Department of Oph-thalmology, University Clinic Hospital, Valladolid, Spain. Tel: 34-983377952; E-mail: [email protected]

Received February 23, 2015; Accepted February 25, 2015; Published February 27, 2015

Citation: Asensio-Sanchez VM, Cano-Suarez M (2015) Orbital Invasion in Nasopharyngeal Carcinoma. J Clin Case Rep 5: i104. doi:10.4172/2165-7920.1000i104

Copyright: © 2015 Asensio-Sanchez VM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Keywords: Nasopharyngeal carcinoma; Regaud pattern; Proptosis

Clinical ImageA 46 year old man was referred for a 3 weeks history of non-

painful proptosis of the left eye. Physical examination revealed a tumor involving the orbital region (Figure 1). Orbital computed tomography imaging showed neoplastic expansive mass spread to the ethmoidal cells (Figure 2). Low-power microscopic examination of the orbital mass showed atypical cells with ovoid vesicular nuclei and prominent nucleoli, with inflammatory infiltrate composed of some eosinophils and lymphocytes. These findings were consistent with the Regaud pattern of undifferentiated nasopharyngeal carcinoma (NC). The tumor showed abundantly expressed Epstein-Barr Virus (EBV) positivity by EBER in-situ hybridization (Figure 3). Although the pathogenesis of the nasopharyngeal carcinoma is not yet clear, it has been suggested that several factors appear: the EBV infection, environmental and genetic factors which are of major importance for the carcinogenesis. Direct orbital invasion is rare in NC. Inferior orbital fissure and the

AbstractA 46 year old man presented with proptosis of the left eye. Extensive explorations revealed undifferentiated

nasopharyngeal carcinoma.

Figure 1:

Figure 3:

Figure 2:

Figure 4:

pterygopalatine fossa are the most common routes of invasion, followed by invasion via the ethmoid sinus. After the patient was treated with radiotherapy and chemotherapy, the mass regress (Figure 4). There were no signs of recurrence after 12 months of follow-up.

Journal of Clinical Case ReportsJour

nal o

f Clinical Case Reports

ISSN: 2165-7920