Ophthalmic complications following treatment of paranasal sinus rhabdomyosarcoma in comparison to orbital disease.
OBJECTIVE
To identify the type and frequency of ocular and orbital complications observed following treatment for primary rhabdomyosarcoma of the paranasal sinuses or the orbit.


METHODS
An institutional review board-approved, Health Insurance Portability and Accountability Act-compliant retrospective chart review was conducted to identify all patients treated at one institution from 1966 to 2005 with biopsy-proven primary paranasal sinus or orbital rhabdomyosarcoma. Pretreatment, treatment, and follow-up data were collected.


RESULTS
Forty-four patients (25 male) of a median age of 7.8 years (range 1.0-18.0 years) with primary paranasal sinus (17) or orbital (27) rhabdomyosarcoma were treated and followed for a median period of 5.3 years (range 0.6-32.0 years). The three most frequently observed ophthalmic complications were persistent eyelid erythema or cellulitis (12), epithelial keratitis (7), and conjunctival injection (6) in the paranasal sinus and epithelial keratitis (18), conjunctival injection (11), and cataract (10) in the orbit. Overall survival after treatment trended higher for the orbital rhabdomyosarcoma group (23 of 27) than the paranasal sinus group (9 of 17).


CONCLUSIONS
The most frequently observed treatment-induced ophthalmic complications in the paranasal sinus group were manageable with minimal patient morbidity, as in the patients with orbital disease. Vision-threatening complications were infrequently encountered. Despite maximal therapy, the mortality rate was higher in the paranasal sinus rhabdomyosarcoma group than in the orbital rhabdomyosarcoma group.
Hamilton Eye Institute, University of Tennessee Health Science Center, St Jude Children's Research Hospital, Memphis, Tennessee, USA.
Parag D
PD
Gandhi
James C
JC
Fleming
Barrett G
BG
Haik
Matthew W
MW
Wilson
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000009:adverse effects; D003609:Dactinomycin / Q000009:adverse effects; D005128:Eye Diseases / Q000139:chemically induced*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009918:Orbital Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000628:therapy*; D010255:Paranasal Sinus Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000628:therapy*; D011832:Radiation Injuries / Q000209:etiology*; D011878:Radiotherapy / Q000009:adverse effects*; D012189:Retrospective Studies; D012208:Rhabdomyosarcoma / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000628:therapy*; D015996:Survival Rate; D014750:Vincristine / Q000009:adverse effects
D003609:Dactinomycin; D014750:Vincristine; D003520:Cyclophosphamide