Cargando…

Successful treatment of metastatic congenital intraocular medulloepithelioma with neoadjuvant chemotherapy, enucleation and superficial parotidectomy

PURPOSE: To report a case of metastatic intraocular medulloepithelioma successfully treated with neoadjuvant chemotherapy, superficial parotidectomy, and enucleation. OBSERVATIONS: A 5-year-old male with history of cataract surgery, glaucoma drainage device, endocyclophotocoagulation, scleral patch...

Descripción completa

Detalles Bibliográficos
Autores principales: Hellman, Justin B., Harocopos, George J., Lin, Lily Koo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6097803/
https://www.ncbi.nlm.nih.gov/pubmed/30128367
http://dx.doi.org/10.1016/j.ajoc.2018.06.019
_version_ 1783348368963010560
author Hellman, Justin B.
Harocopos, George J.
Lin, Lily Koo
author_facet Hellman, Justin B.
Harocopos, George J.
Lin, Lily Koo
author_sort Hellman, Justin B.
collection PubMed
description PURPOSE: To report a case of metastatic intraocular medulloepithelioma successfully treated with neoadjuvant chemotherapy, superficial parotidectomy, and enucleation. OBSERVATIONS: A 5-year-old male with history of cataract surgery, glaucoma drainage device, endocyclophotocoagulation, scleral patch grafting, and chronic posterior “inflammation” in a blind left eye presented with a rapidly enlarging painful mass under the left upper eyelid. Biopsy of the conjunctival mass and fine needle aspiration of an enlarged preauricular lymph node revealed medulloepithelioma, which was also seen in the left parotid gland on positron emission tomography (PET) scan. The patient's father refused exenteration, so the patient received 3 cycles of vincristine, cisplatin, cyclophosphamide, and etoposide per a retinoblastoma protocol. Repeat magnetic resonance imaging (MRI) showed regression of ocular extension, and an enucleation was performed, histologically confirming the diagnosis of malignant, non-teratoid medulloepithelioma. The child later underwent superficial parotidectomy and received an additional round of chemotherapy. There has been no evidence of recurrence for 9 years. CONCLUSIONS AND IMPORTANCE: There is no standard treatment for metastatic intraocular medulloepithelioma. The neoadjuvant chemotherapy regimen used in our patient led to regression of the extrascleral extension of the tumor, allowing for enucleation rather than a more disfiguring exenteration, as well as likely improving his prognosis. We believe that it is reasonable to consider neoadjuvant chemotherapy for patients with extrascleral and/or metastatic medulloepithelioma.
format Online
Article
Text
id pubmed-6097803
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-60978032018-08-20 Successful treatment of metastatic congenital intraocular medulloepithelioma with neoadjuvant chemotherapy, enucleation and superficial parotidectomy Hellman, Justin B. Harocopos, George J. Lin, Lily Koo Am J Ophthalmol Case Rep Case report PURPOSE: To report a case of metastatic intraocular medulloepithelioma successfully treated with neoadjuvant chemotherapy, superficial parotidectomy, and enucleation. OBSERVATIONS: A 5-year-old male with history of cataract surgery, glaucoma drainage device, endocyclophotocoagulation, scleral patch grafting, and chronic posterior “inflammation” in a blind left eye presented with a rapidly enlarging painful mass under the left upper eyelid. Biopsy of the conjunctival mass and fine needle aspiration of an enlarged preauricular lymph node revealed medulloepithelioma, which was also seen in the left parotid gland on positron emission tomography (PET) scan. The patient's father refused exenteration, so the patient received 3 cycles of vincristine, cisplatin, cyclophosphamide, and etoposide per a retinoblastoma protocol. Repeat magnetic resonance imaging (MRI) showed regression of ocular extension, and an enucleation was performed, histologically confirming the diagnosis of malignant, non-teratoid medulloepithelioma. The child later underwent superficial parotidectomy and received an additional round of chemotherapy. There has been no evidence of recurrence for 9 years. CONCLUSIONS AND IMPORTANCE: There is no standard treatment for metastatic intraocular medulloepithelioma. The neoadjuvant chemotherapy regimen used in our patient led to regression of the extrascleral extension of the tumor, allowing for enucleation rather than a more disfiguring exenteration, as well as likely improving his prognosis. We believe that it is reasonable to consider neoadjuvant chemotherapy for patients with extrascleral and/or metastatic medulloepithelioma. Elsevier 2018-06-21 /pmc/articles/PMC6097803/ /pubmed/30128367 http://dx.doi.org/10.1016/j.ajoc.2018.06.019 Text en © 2018 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case report
Hellman, Justin B.
Harocopos, George J.
Lin, Lily Koo
Successful treatment of metastatic congenital intraocular medulloepithelioma with neoadjuvant chemotherapy, enucleation and superficial parotidectomy
title Successful treatment of metastatic congenital intraocular medulloepithelioma with neoadjuvant chemotherapy, enucleation and superficial parotidectomy
title_full Successful treatment of metastatic congenital intraocular medulloepithelioma with neoadjuvant chemotherapy, enucleation and superficial parotidectomy
title_fullStr Successful treatment of metastatic congenital intraocular medulloepithelioma with neoadjuvant chemotherapy, enucleation and superficial parotidectomy
title_full_unstemmed Successful treatment of metastatic congenital intraocular medulloepithelioma with neoadjuvant chemotherapy, enucleation and superficial parotidectomy
title_short Successful treatment of metastatic congenital intraocular medulloepithelioma with neoadjuvant chemotherapy, enucleation and superficial parotidectomy
title_sort successful treatment of metastatic congenital intraocular medulloepithelioma with neoadjuvant chemotherapy, enucleation and superficial parotidectomy
topic Case report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6097803/
https://www.ncbi.nlm.nih.gov/pubmed/30128367
http://dx.doi.org/10.1016/j.ajoc.2018.06.019
work_keys_str_mv AT hellmanjustinb successfultreatmentofmetastaticcongenitalintraocularmedulloepitheliomawithneoadjuvantchemotherapyenucleationandsuperficialparotidectomy
AT harocoposgeorgej successfultreatmentofmetastaticcongenitalintraocularmedulloepitheliomawithneoadjuvantchemotherapyenucleationandsuperficialparotidectomy
AT linlilykoo successfultreatmentofmetastaticcongenitalintraocularmedulloepitheliomawithneoadjuvantchemotherapyenucleationandsuperficialparotidectomy