title: "Tag-Team" Orbital and Strabismus Surgeries with Immediate Reconstruction After Tumor Excision Metastatic to the Inferior Rectus.
abstract: Carcinoid tumors are rare, slow-growing, low-grade neuroendocrine tumors with a propensity for orbital metastatic spread. The typical treatment paradigm for localized orbital disease involves excision, adjuvant radiotherapy, and/or receptor-targeted chemotherapy, followed by delayed evaluation for reconstructive strabismus surgery. We present a 58-year-old female patient with carcinoid tumor metastatic to the right inferior rectus muscle who presented with worsening binocular diplopia. The patient underwent coordinated "tag-team" orbital and strabismus surgeries that included excision of the right inferior rectus muscle to the annulus of Zinn followed immediately by reconstructive strabismus surgery. The patient required 1 additional strabismus surgery 1 year later. Follow up revealed no tumor recurrence at 4 years, and excellent binocular vision with good function. Deep orbital and strabismus surgeries, when performed simultaneously in a "tag-team" approach, may offer superior functional outcomes and improved patient quality of life, with expedited functional recovery. This approach may become a new treatment paradigm for surgical disease processes localized to the extraocular muscles.
authors: Department of Ophthalmology and Visual Sciences, WK Kellogg Eye Center, University of Michigan, Ann Arbor, MI.
authors: Chris Y
authors: CY
authors: Wu
authors: Steven M
authors: SM
authors: Archer
authors: Alon
authors: A
authors: Kahana
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism; D002276:Carcinoid Tumor / Q000000981:diagnostic imaging / Q000378:metabolism / Q000556:secondary / Q000601:surgery*; D053379:Chromogranin A / Q000378:metabolism; D004172:Diplopia / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006801:Humans; D007078:Ileal Neoplasms / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D019042:Muscle Neoplasms / Q000000981:diagnostic imaging / Q000378:metabolism / Q000556:secondary / Q000601:surgery*; D009801:Oculomotor Muscles / Q000473:pathology / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D009916:Orbital Diseases / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D011877:Radionuclide Imaging; D019651:Plastic Surgery Procedures; D013285:Strabismus / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*
chemical_list: D014408:Biomarkers, Tumor; D053379:Chromogranin A