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Metastasis to the optic nerve: clinicopathological correlations
G S Allaire1, C Corriveau, J D Arbour
1Department of Pathology, Hôpital Notre-Dame, Montreal, PQ.
Objective:
To describe the clinical, radiologic and histopathological features of two cases of carcinoma metastatic to the optic nerve with different pathways of spread.
Design:
Chart review.
Setting:
Oncology clinic in Montreal.
Patients:
One patient previously treated for breast carcinoma and one patient previously treated for small-cell carcinoma of the lung.
Results:
The patient with breast carcinoma was found to have an elevated mass involving her right optic nerve head. This finding was confirmed by B-scan ultrasonography. The other patient initially presented with left retinal metastasis and subsequently manifested massive secondary involvement of the ipsilateral optic nerve, documented by computed tomography. Both patients were initially treated with radiotherapy to the eye and orbit, but postmortem histopathological study showed that this treatment had little effect on the tumour.
Conclusions:
The histopathological observations suggest that if radiotherapy is to be used in the treatment of metastasis to the optic nerve, the dosage of radiation should be higher than that recommended for the treatment of choroidal metastasis.