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| Abstract ID | 13-021 |
| Title | Metastatic intraorbital disease via perineural spread from atypical squamous cell carcinoma of the lip in a patient with previously treated orbital lymphoma |
| Oral, Poster or Video? | I would accept only poster presentation |
| temp | |
| Review result | [518] |
| Purpose |
– To describe the rare presentation of perineural spread of atypical SCC in the infraorbital nerve – To discuss recommended investigations for detecting orbital metastatic disease via perineural spread. – To discuss the role of orbital exenteration in the management of advanced orbital malignancy |
| Methods |
We present the interesting case of a 65 year old Caucasian gentleman who was originally diagnosed and successfully treated for orbital MALT cell lymphoma causing external compression of the lacrimal sac. He presents 7 years later with very atypical SCC of the lip, paraesthesia of the cheek and initial normal orbital imaging. High definition orbital imaging, Hess charts and photomicrographs are presented. |
| Results |
Incisional biopsy of a lesion arising from the roof of the bony infraorbital canal showed a diagnosis of SCC . He underwent orbital exenteration with clearance of his ptyregopalatine fossa and right maxillectomy with adjuvant radiotherapy. Histology showed advanced perineural spreading SCC up to the pterygopalatine fossa with identical morphology to his previously excised upper lip squamous cell cancer. We discuss the role of exenteration surgery in the management of advanced metastatic SCC to the orbit and the pathophysiology and management difficulties of perineural spreading SCC. |
| Conclusion |
The need for a thorough cranial nerve examination in the follow up of patients with a known history of head and neck SCC, specifically extra ocular movements, facial sensation and cervical lymphadenopathy which may indicate metastatsis or more devastatingly orbital invasion. |
