title: Metastasis to the orbit from transitional cell carcinoma of the bladder.
abstract: OBJECTIVE
  To demonstrate the pathological features of the extremely rare metastatic transitional cell carcinoma (TCC) from the bladder to the orbit, and to review the literature on metastatic TCC to the orbit.
  
  
  METHODS
  A 74-year-old man experienced 2 weeks of red eye, proptosis, diplopia, pain, and visual loss in the right eye. Three years previous to the current presentation, the patient had undergone a transurethral resection for superficial and moderately differentiated TCC of the bladder. A transseptal anterior orbitotomy was performed.
  
  
  RESULTS
  Histopathological examination of the orbital lesion revealed nests of carcinomatous cells. Atypical pleomorphic cells with vacuolated cytoplasm were evident. The cellular morphology of the orbital lesion was identical to that of the primary TCC. There have been 12 previously reported cases of metastases to the orbit from TCC of the bladder, with the time from onset of primary TCC to observation of ocular symptoms ranging from 3 weeks to 11 years. Mean survival after orbital metastasis developed from TCC was 3.0 months.
  
  
  CONCLUSIONS
  This study presents a detailed description of the pathological features of metastatic TCC in the orbit. In cases of orbital metastasis from TCC, patient prognosis is very poor.
authors.affiliation: Department of Ophthalmology, Jikei University School of Medicine, Tokyo, Japan. shiki@jikei.ac.jp.
authors.forename: Keigo
authors.initials: K
authors.lastname: Shikishima
authors.affiliation: Department of Ophthalmology, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Miyake
authors.affiliation: Department of Urology, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Isao
authors.initials: I
authors.lastname: Ikemoto
authors.affiliation: Department of Pathology, Clinical Service, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Makio
authors.initials: M
authors.lastname: Kawakami
mesh_terms: D000368:Aged; D001706:Biopsy; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery; D015653:Cystectomy; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D013508:Ophthalmologic Surgical Procedures; D009918:Orbital Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery