title: Orbital metastasis of hepatocellular carcinoma.
abstract: We report a 74-year-old woman who presented with an orbital apex syndrome and pulsatile proptosis. CT showed a right orbital mass that destroyed the orbital sphenoid bone and extended intracranially. Biopsy revealed metastatic hepatocellular carcinoma (HCC), and subsequent investigations demonstrated a high level of serum-fetoprotein and a huge liver mass. The patient died shortly after the biopsy. Rarely reported in the English literature, metastatic HCC is common in Asia, perhaps because of a racial predisposition together with a relatively high prevalence of alcoholic cirrhosis, chronic hepatitis B and C, and exposure to aflatoxins.
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. parima.h@chula.ac.th
authors.forename: Parima
authors.initials: P
authors.lastname: Hirunwiwatkul
authors.forename: Suppapong
authors.initials: S
authors.lastname: Tirakunwichcha
authors.forename: Piyawadee
authors.initials: P
authors.lastname: Meesuaypong
authors.forename: Shanop
authors.initials: S
authors.lastname: Shuangshoti
mesh_terms: D000368:Aged; D000437:Alcoholism / Q000150:complications; D044466:Asian People; D014408:Biomarkers, Tumor / Q000032:analysis / Q000097:blood; D001706:Biopsy; D001763:Blepharoptosis / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D006528:Carcinoma, Hepatocellular / Q000208:ethnology / Q000556:secondary*; D018450:Disease Progression; D005094:Exophthalmos / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D017809:Fatal Outcome; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000208:ethnology / Q000473:pathology*; D009915:Orbit / Q000473:pathology* / Q000503:physiopathology; D009918:Orbital Neoplasms / Q000503:physiopathology / Q000556:secondary*; D012307:Risk Factors; D013785:Thailand; D014057:Tomography, X-Ray Computed; D015354:Vision, Low / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D000509:alpha-Fetoproteins / Q000032:analysis / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; D000509:alpha-Fetoproteins