Clinical features and treatment of seven patients with carcinoid tumor metastatic to the eye and orbit.

ABSTRACT

PURPOSE: To understand better the clinical features, treatment, and outcome of patients with carcinoid tumors metastatic to the eye and orbit. METHODS: We studied seven patients with carcinoid tumors metastatic to the eye and orbit who were initially examined at the Mayo Clinic between 1974 and 1992. Carcinoid tumors metastasized to the choroid of six eyes of four patients and unilaterally to the orbit in three additional patients. RESULTS: Decreased vision was the most frequent initial symptom with choroidal metastases. Choroidal metastases were treated with brachytherapy only, with brachytherapy and chemotherapy, with external beam irradiation and chemotherapy, or with chemotherapy only. The duration of follow-up of these four patients ranged from seven to eight years after the diagnosis of choroidal metastases. Two of the four patients died from tumor complications 7 1/2 and seven years after the diagnosis of choroidal metastases. Proptosis and limitation of ocular motility were the most common initial signs with orbital metastases. Orbital metastases were treated with external beam irradiation and chemotherapy, with chemotherapy only, or with external beam irradiation only. Duration of follow-up of these three patients ranged from one-half to two years after the diagnosis of orbital metastases. All three patients died from tumor complications during the follow-up period. CONCLUSIONS: Because of the relatively good prospects for long-term survival in patients with carcinoid tumors metastatic to the choroid, early detection and treatment of the metastases are important.