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Orbital Invasion in Nasopharyngeal Carcinoma | OMICS International
ISSN: 2165-7920
Journal of Clinical Case Reports
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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 Ophthalmology
University Clinic Hospital, Valladolid, Spain
Tel: 34-983377952
Email: [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.

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Abstract

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

Keywords
Nasopharyngeal carcinoma; Regaud pattern; Proptosis
Clinical Image
A 46 year old man was referred for a 3 weeks history of nonpainful 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 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.

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