Metastasis of advanced gastric cancer to the extraocular muscle: a case report.

BACKGROUND: Metastatic tumors in the orbit, especially from gastric cancer, are rare. We present a rare case of extraocular muscle metastasis from gastric cancer and raise consideration of metastasis to extraocular muscle as a differential diagnosis of proptosis/lid swelling in a patient with history of malignancy. CASE PRESENTATION: A 54-year-old Japanese woman presented with proptosis, lid swelling, diplopia, and retro-orbital pain in her left eye, which she had been experiencing for 1 day. She had a medical history of poorly differentiated adenocarcinoma of the stomach, which had metastasized to several organs. A computed tomography scan showed enlargement of the medial rectus muscle in her left eye. She was diagnosed as having gastric cancer metastasis to the medial rectus muscle of her left eye, and received a total of 20 Gy radiation therapy to the orbit, which resulted in resolution of her ocular symptoms. She died 3 months after her initial visit to our ophthalmic department. CONCLUSIONS: Metastasis from malignancy should be considered in the differential diagnosis of a patient presenting with proptosis or lid swelling who has a history of gastric cancer. Radiation therapy of metastases in the orbit may be an effective treatment in such cases.

[A case of recurrent lung cancer with bone metastases treated with tegafur-uracil and zoledronic acid for long-term survival].

We present the case of an 84-year-old man with lumbago due to bone metastases from lung cancer that recurred three years after surgery. The patient received carboplatin-paclitaxel combination as first-line chemotherapy for the treatment of lung cancer, and palliative radiotherapy for the treatment of bone metastases. Gemcitabine was administered as second-line chemotherapy. However, disease progression was observed after three years, and he developed pulmonary metastases. The general condition of the patient worsened, and tegafur-uracil chemotherapy was initiated. Zoledronic acid was also administered. The tegafur-uracil treatment resulted in the disappearance of pulmonary metastases, and a stabilization of the bone metastases. Disease progression was observed after 6 years with a recurrence of pulmonary metastases; however, this did not have a negative impact on the patient's quality of life. Although slow progression may be inherent to lung cancers, it is also possible that the tegafur-uracil and zoledronic acid combination might have contributed to the patient's improved performance.