A Long Way From Home
Author: Daphna Landau
Base Hospital / Institution: Sheba Medical Center
Video presentation
Abstract ID: 25-145
Purpose
A 63-year-old female presented with a new, nonpainful right temporal swelling. Her past medical history was significant for uterine leiomyosarcoma, which was treated with surgery and chemotherapy seven years ago, with no evidence of recurrence since. MRI revealed a large lesion involving the greater wing of the sphenoid, infiltrating both the posterior superolateral orbit and the infratemporal area, with suspected dural involvement.
Methods
A biopsy confirmed metastatic leiomyosarcoma, an exceptionally rare occurrence of orbital metastasis. A multidisciplinary evaluation determined that the tumor was not amenable to chemotherapy or radiotherapy, leading to a decision for surgical debulking.
Results
The procedure was performed using an extended eyelid crease approach and lateral orbitotomy, followed by piecemeal debulking of the metastasis and bony drilling around the tumor.
Conclusion
Postoperative orbital CT indicated gross total resection. The patient remains under close multidisciplinary surveillance.
Link to surgical video:
https://www.dropbox.com/scl/fi/6g67as2dfitiirbyak0bb/A-long-way-from-home-240325.mp4?rlkey=jypoq9md08oi5g8kv8fw3bt31&st=2rp43shn&dl=0
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