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      Bilateral multiple extraocular muscle metastasis from hepatocellular carcinoma

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          Abstract

          Hepatocellular carcinoma (HCC) rarely metastasizes to the extra ocular muscles (EOMs). We present a case of bilateral metastasis of HCC to the EOMs and focus on the magnetic resonance imaging (MRI) features. Orbital MRI revealed nodular enlargement of bilateral multiple EOMs, with isointensity on T1-weighted images and heterogeneous, intermediate-to-high signal intensity on T2-weighted images, and showed mild-to-significant heterogeneous contrast enhancement with gadolinium. Physicians should be aware of this rare cause of EOM enlargement, understand the radiologic characteristics of EOM metastasis, and thus make appropriate treatment strategy.

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          Most cited references 14

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          The incidence of ocular metastatic carcinoma.

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            Clinical practice. Graves' ophthalmopathy.

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              Orbital metastases: diagnosis and course.

              Three issues were investigated in adult outpatients with orbital metastases. One, how accurate are current diagnostic methods? Two, what is the survival associated with orbital metastases? Three, did any clinical factors correlate with prognosis in this patient cohort? Retrospective analysis of patients with orbital metastases managed in an ocular oncology unit. 11 of 31 (35%) patients had no known primary malignancy at the time of orbital diagnosis. In eight of 31 (26%) computed tomography and/or magnetic resonance imaging data did not yield the diagnosis of metastases. In 15 of 17 (88%) cases a fine needle aspiration biopsy was diagnostic. Several types of therapy were used. The median survival was 1.3 years. Orbital metastases, even with newer diagnostic techniques can be difficult to diagnose. Management was based on location and extent of both orbital and systemic disease as well as vision. In most cases, orbital symptoms were palliated; however, survival was dismal. No clinical factor correlated with prognosis.
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                Author and article information

                Journal
                Acta Radiol Short Rep
                Acta Radiol Short Rep
                ARR
                sparr
                Acta Radiologica Short Reports
                SAGE Publications (Sage UK: London, England )
                2047-9816
                February 2012
                12 January 2012
                : 1
                : 1
                Affiliations
                [1 ]Department of Radiology
                [2 ]Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University , Beijing, China
                Author notes
                Correspondence to: Zhenchang Wang. Email: cjr.wzhch@ 123456vip.163.com
                Article
                10.1258_arsr.2011.110002
                10.1258/arsr.2011.110002
                3738330
                23986821
                © 2012 The Foundation Acta Radiologica

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by-nc/2.0/), which permits non-commercial use, distribution and reproduction in any medium, provided the original work is properly cited.

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