Quick AM, Bloomston M, Kim EY, Hall NC, Mayr NA. Complete response to radiation therapy of orbital metastasis from hepatocellular carcinoma. World J Gastroenterol 2009; 15(47): 6000-6003 [PMID: 20014466 DOI: 10.3748/wjg.15.6000]
Corresponding Author of This Article
Nina A Mayr, MD, Department of Radiation Medicine, Arthur G. James Cancer Hospital, The Ohio State University Medical Center, Columbus, OH 43210, United States. nina.mayr@osumc.edu
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Dec 21, 2009; 15(47): 6000-6003 Published online Dec 21, 2009. doi: 10.3748/wjg.15.6000
Complete response to radiation therapy of orbital metastasis from hepatocellular carcinoma
Allison M Quick, Mark Bloomston, Edward Y Kim, Nathan C Hall, Nina A Mayr
Allison M Quick, Edward Y Kim, Nina A Mayr, Department of Radiation Medicine, Arthur G. James Cancer Hospital, The Ohio State University Medical Center, Columbus, OH 43210, United States
Mark Bloomston, Department of Surgical Oncology, The Ohio State University Medical Center, Columbus, OH 43210, United States
Nathan C Hall, Department of Radiology, The Ohio State University Medical Center, Columbus, OH 43210, United States
Author contributions: Quick AM wrote the manuscript and performed additional data analysis; Mayr NA, Hall NC and Bloomston M provided patient data and approved the final manuscript; Kim EY approved the final manuscript.
Supported by NIH/NCI K12 CA133250-01
Correspondence to: Nina A Mayr, MD, Department of Radiation Medicine, Arthur G. James Cancer Hospital, The Ohio State University Medical Center, Columbus, OH 43210, United States. nina.mayr@osumc.edu
Telephone: +1-614-2938415 Fax: +1-614-2934044
Received: August 27, 2009 Revised: October 15, 2009 Accepted: October 22, 2009 Published online: December 21, 2009
Abstract
The incidence of hepatocellular carcinoma (HCC) is increasing in the United States, and 50%-75% of patients with HCC will develop metastatic disease. Orbital metastases from HCC are extremely rare. We report the case of a 52-year-old male with known metastatic HCC, who presented with severe proptosis and diplopia. An orbital mass was identified on magnetic resonance imaging (MRI) and confirmed to have hypermetabolic activity on positron emission tomography/computed tomography. He received a palliative course of external beam radiation therapy to the right orbit. Intensity modulated radiation therapy (IMRT) was used to allow sparing of critical normal tissues in close proximity to the tumor. One month after completion of IMRT to 58 Gray in 30 fractions delivered over 6 wk, the patient had a complete clinical, radiologic (MRI) and symptomatic response. The patient continues to have local control in the orbit 1.7 years after therapy completion. All critical normal structures were kept below the tolerance dose using IMRT, and no toxicities were observed.
