Late-onset chemosis in patients with head or neck tumors.
OBJECTIVE
To describe a series of patients with chemosis and a history of head or neck tumor, and to propose possible mechanisms for the findings.


METHODS
Retrospective, consecutive case series (1993-2001), with review of: site and histopathologic type of the primary tumor; dates and details of tumor treatment; approximate date of chemosis onset; ocular findings and results of orbital, head, and neck imaging upon referral to the authors; and follow-up outcome.


RESULTS
Three male and 3 female patients ranged from 35-68 years of age. Primary tumors were adenoid cystic carcinomas of minor salivary glands of the buccal sulcus (1) and the anterior palate (1), squamous cell carcinomas of the posterior hard palate (1) and the nasopharynx (1), and pleomorphic adenomas of the parotid gland (2). Tumor treatment involved surgery alone (2), surgery and radiation (3), or radiation alone (1). Exposure of regional lymphatics ranged from 50-68 Gy; in 2 cases, orbital exposure was 58-60 Gy. Intervals from treatment to chemosis onset ranged from 5-59 months (mean, 25 months). Imaging showed no orbital mass, recurrence at the primary site, or nodal enlargement in any case. Chemosis remained relatively stable, and no tumor recurrence was noted in additional follow-up of 12-132 months (median, between 26 and 33 months).


CONCLUSIONS
Patients with chemosis and a history of head or neck tumor should be evaluated for tumor recurrence at the primary site, in regional nodes, and in the orbital apex. However, the finding may be a delayed sequela of surgery and/or radiation.
Harris
Gerald J
GJ
Departments of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin 53226-4812, USA.
Woo
Kyung In
KI
Schultz
Christopher J
CJ
Tayani
Ramin
R
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Efrain M
EM
D000328:Adult; D000368:Aged; D003229:Conjunctival Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D004487:Edema / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome