Chronic orbital inflammation and fibrosis after retrobulbar alcohol and chlorpromazine injections in a patient with choroidal melanoma.
A 59-year-old woman developed a choroidal melanoma in her right eye and was successfully treated with plaque radiotherapy in 1995. She subsequently developed a blind, painful eye and was treated with retrobulbar alcohol and chlorpromazine injections. A transient acute severe inflammatory reaction to chlorpromazine was noted, and chronic pain persisted. MRI performed 5 months later revealed diffuse orbital enhancement suggestive of either fibrosis or tumor recurrence. Following enucleation, diffuse orbital fibrosis was confirmed. The unusual fibrosis could have been related to the orbital injections or remotely related to long-term effects of radiotherapy.
Cotliar
Jeremy M
JM
Department of Ophthalmology, Lions Eye Institute, Albany Medical College, Albany, New York 12159, USA. cotliaj@mail.amc.edu
Shields
Carol L
CL
Meyer
Dale R
DR
D001766:Blindness / Q000188:drug therapy / Q000209:etiology; D001918:Brachytherapy; D002746:Chlorpromazine / Q000009:adverse effects*; D002830:Choroid Neoplasms / Q000532:radiotherapy*; D002908:Chronic Disease; D004359:Drug Therapy, Combination; D000431:Ethanol / Q000009:adverse effects*; D015353:Eye Enucleation; D005260:Female; D005355:Fibrosis / Q000139:chemically induced / Q000175:diagnosis; D006801:Humans; D007267:Injections; D008279:Magnetic Resonance Imaging; D008545:Melanoma / Q000532:radiotherapy*; D008875:Middle Aged; D009915:Orbit / Q000473:pathology*; D016727:Orbital Pseudotumor / Q000139:chemically induced* / Q000175:diagnosis; D010146:Pain / Q000188:drug therapy / Q000209:etiology
D000431:Ethanol; D002746:Chlorpromazine