title: Paraneoplastic syndrome--unresponsive systemic hypertension and fever as expression of primitive ciliary body carcinoma in a blind painful eye: a case report.
abstract: BACKGROUND
  The purpose of this study was to present a case of paraneoplastic systemic hypertension and fever in an undiagnosed primary ciliary body carcinoma arising in a painful blind eye.
  
  
  METHODS
  A 37-year-old white man with a history of blindness since childhood was enucleated for neovascular glaucoma because of intractable pain in his right eye. A histopathological examination revealed a ciliary body carcinoma. One year later, an invasive recurrence of his orbit and ethmoid was detected and a debulking procedure was performed. He had untreatable fever and multidrug-resistant systemic hypertension for 3 months before the neoplasm diagnosis. He recovered from fever and systemic hypertension only after tumor excision and relapsed 1 year later when synchronous tumor dissemination was shown through a computed tomography scan. Tumor metastases, despite surgery and chemotherapy, caused his death.
  
  
  CONCLUSIONS
  Paraneoplastic symptoms such as fever and hypertension may be due to unrecognized ocular malignancy. This case report intends to emphasize the importance of histopathological examination of an enucleated phthisical painful blind eye.
authors.affiliation: Department of Ophthalmology, Istituto Clinico Humanitas, IRCCS, Via Alessandro Manzoni 56, 20089, Rozzano, MI, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Balia
authors.affiliation: Department of Ophthalmology, Istituto Clinico Humanitas, IRCCS, Via Alessandro Manzoni 56, 20089, Rozzano, MI, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Vinciguerra
authors.affiliation: Department of Ophthalmology, Istituto Clinico Humanitas, IRCCS, Via Alessandro Manzoni 56, 20089, Rozzano, MI, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Di Maria
authors.affiliation: Department of Ophthalmology, Istituto Clinico Humanitas, IRCCS, Via Alessandro Manzoni 56, 20089, Rozzano, MI, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Piscopo
authors.affiliation: Department of Ophthalmology, Istituto Clinico Humanitas, IRCCS, Via Alessandro Manzoni 56, 20089, Rozzano, MI, Italy. mary.romano@tin.it.|Department of Ophthalmology, Second University of Neaples, Naples, Italy. mary.romano@tin.it.
authors.forename: Mary
authors.initials: M
authors.lastname: Romano
mesh_terms: D000328:Adult; D002924:Ciliary Body / Q000473:pathology*; D018432:Drug Resistance, Multiple; D017809:Fatal Outcome; D005334:Fever / Q000209:etiology*; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000601:surgery; D059545:Paraneoplastic Syndromes, Ocular / Q000175:diagnosis* / Q000473:pathology; D014604:Uveal Neoplasms / Q000473:pathology*