Unilateral proptosis as the initial manifestation of malignancy

Proptosis, a common sign with a broad differential diagnosis, is defined as anterior displacement and protrusion of one or both orbital globes. Patients can present with varying degrees of chronicity, visual loss and associated symptoms. The etiology of acquired unilateral proptosis is diverse, ranging from benign to life-threatening. The causes of unilateral proptosis include traumatic, vascular, endocrine, inflammatory, infective and malignant. Breast carcinoma is the most common metastatic cause of proptosis; however, proptosis has never been reported as the initial manifestation of breast carcinoma. Our patient presented with unilateral proptosis secondary to an intraorbital lesion and histopathology of orbital lesion was suggestive of metastatic breast adenocarcinoma. She was later diagnosed to have primary breast carcinoma. We present this unusual case of a 56-year-old woman who presented with proptosis as the initial manifestation of a metastatic breast malignancy

Ectopic meningioma presenting as a neck mass: case report and review of literature

Abstract Background Ectopic meningiomas are rare neoplasms that occur entirely outside the intracranial and intraspinal cavities and account for only 1–2% of all meningiomas. These tumors have been reported at various sites, however they are predominantly observed in the head and neck region. Here, we detail a case of an adult diagnosed with ectopic meningioma of the neck. Case presentation A 26-year-old woman underwent evaluation for a neck swelling associated with difficult in swallowing. Clinical examination revealed a firm, non-tender and non-pulsatile swelling in the right side of neck. On imaging, a soft tissue mass lesion was seen involving the right supra-hyoid neck, centered at the right carotid space/retro-styloid parapharyngeal space. She underwent maximal safe resection of the tumor and a consensus was reached regarding the diagnosis of ectopic meningioma based on the histopathological, clinical and radiological findings. Relevant literature is reviewed. Conclusions The diagnosis of ectopic meningioma may pose difficulties due to their occurrence in uncommon sites. The primary approach to treatment entails the surgical removal of the neoplasm, and a multidisciplinary strategy is pivotal for achieving the best possible clinical outcomes for patients with this rare entity

Radiosurgery for Arteriovenous Malformations Using Micro–Multi-leaf Collimators: Analyses of Outcome

Aim To assess the outcome of patients with AVMs treated using micro-MLC–based radiosurgery at Regional Cancer Centre (RCC), Thiruvananthapuram. Materials and Methods During January 1 to December 31, 2012, 24 patients were treated with stereotactic radiosurgery (SRS) at RCC. The median age was 28 years (range: 8–58 years). There were 11 males and 13 females. Fifteen patients had prior embolization. All patients were treated with a frameless radiosurgery system using micro-MLC–based linear accelerator (LINAC). Obliteration of the lesion was assessed with either magnetic resonance angiogram (MRA) or digital subtraction angiography (DSA). Results Nineteen patients who underwent an assessment procedure were evaluable for this study. At median follow-up of 12 months, nearly two-thirds of patients had complete obliteration of the AVM and the rest had partial obliteration. Among patients with complete obliteration, seven patients had an AVM volume of ≤ 3 cc and three-fourths of the patients had AVM score of &lt; 1.5. Further, marginal dose of &gt; 18 Gy resulted in higher obliteration. One patient had an episode of seizure after SRS. No complications or bleed was seen in any of the patients after treatment. Conclusion Our experience correlates with the existing literature reports, without any significant complications. Longer follow-up is required to assess the complete obliteration and late complications.</jats:p