Abstract

Case Report

Acute Inflammatory Reaction After Radiotherapy to Bilateral Orbital Metastasis from Melanoma

Christopher J Issa, Batoul Nasser*, Batoul Mazraani, Kevin T Eid, Bailey Loving and Thomas J Quinn and Muayad F Almahariq

Published: 15 September, 2023 | Volume 7 - Issue 3 | Pages: 056-057

Orbital melanoma is a subtype of periocular melanoma that can present from primary, secondary (arising from local invasion), or metastatic disease [1]. Melanoma metastasis to the orbit is rare with the majority of metastases occurring in subcutaneous tissue, nonregional lymph nodes, lungs, liver, brain, and bone [2]. Despite melanoma being relatively radioresistant, radiation therapy can be considered in an adjuvant or palliative setting [3]. In the palliative setting specifically, radiation therapy is highly effective in alleviating symptoms due to mass effect [3]. However, significant ocular and orbital complications may occur as a direct result of radiation therapy.

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References

  1. Rose AM, Luthert PJ, Jayasena CN, Verity DH, Rose GE. Primary Orbital Melanoma: Presentation, Treatment, and Long-term Outcomes for 13 Patients. Front Oncol. 2017 Dec 18;7:316. doi: 10.3389/fonc.2017.00316. PMID: 29326884; PMCID: PMC5741819.
  2. Rose AM, Cowen S, Jayasena CN, Verity DH, Rose GE. Presentation, Treatment, and Prognosis of Secondary Melanoma within the Orbit. Front Oncol. 2017 Jun 23;7:125. doi: 10.3389/fonc.2017.00125. PMID: 28690979; PMCID: PMC5481311.
  3. Shi W. Radiation Therapy for Melanoma. In: Ward WH, Farma JM, editors. Cutaneous Melanoma: Etiology and Therapy [Internet]. Brisbane (AU): Codon Publications; 2017 Dec 21. Chapter 8. PMID: 29461772.
  4. Greene DP, Shield DR, Shields CL, Shields JA, Servat JJ, Lin CJ, Douglass AM, Fulco EA, Levin F. Cutaneous melanoma metastatic to the orbit: review of 15 cases. Ophthalmic Plast Reconstr Surg. 2014 May-Jun;30(3):233-7. doi: 10.1097/IOP.0000000000000075. PMID: 24811686.
  5. Ioakeim-Ioannidou M, MacDonald SM. Evolution of Care of Orbital Tumors with Radiation Therapy. J Neurol Surg B Skull Base. 2020 Aug;81(4):480-496. doi: 10.1055/s-0040-1713894. Epub 2020 Aug 24. PMID: 33072488; PMCID: PMC7561458.
  6. Di Maggio FM, Minafra L, Forte GI, Cammarata FP, Lio D, Messa C, Gilardi MC, Bravatà V. Portrait of inflammatory response to ionizing radiation treatment. J Inflamm (Lond). 2015 Feb 18;12:14. doi: 10.1186/s12950-015-0058-3. PMID: 25705130; PMCID: PMC4336767.

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