Ophthalmic artery embolization as pretreatment of orbital exenteration for conjunctival squamous cell carcinoma

Toshihiko Matsuo, Nobuya Ohara, Yuzaburo Namba, Isao Koshima, Kentaro Ida, Susumu Kanazawa

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

The aim of this study is to describe the effect of transarterial embolization from the ophthalmic artery as a pretreatment for orbital exenteration. A 75-year-old Chinese man with a 7-year history of gradual increase of the left eye swelling showed a massive conjunctival tumor growing outwardly from the interpalpebral fissure and had no light perception in the left eye. Magnetic resonance imaging showed orbital invasion of the tumor around the left eyeglobe. The initial surgery for the planned orbital exenteration was discontinued after skin incision around the orbital margin due to massive hemorrhage. The patient underwent transarterial embolization with gelatin sponge (Spongel) of the feeding arteries from the left ophthalmic artery and, the next day, had orbital exenteration with well-controllable bleeding and reconstruction with free vascularized anterolateral thigh cutaneous flap transfer. Pathologically, well-differentiated squamous cell carcinoma proliferated in exophytic, papillary, and nested fashions, arising from the bulbar conjunctiva. Tumor cells were also found in the conjunctival stroma around the vessels. The sclera at the equator had a perforated site with tumor cell invasion, but no intraocular invasion was found. Hematoxylin-positive gelatin sponges were found inside the orbital vessels and large choroidal vessels. In conclusion, transarterial embolization of feeding arteries arising from the ophthalmic artery is a useful pretreatment to control bleeding at orbital exenteration for malignancy.

Original languageEnglish
Pages (from-to)554-557
Number of pages4
JournalCardiovascular and Interventional Radiology
Volume32
Issue number3
DOIs
Publication statusPublished - May 1 2009

Keywords

  • Anterolateral thigh flap
  • Conjunctival squamous cell carcinoma
  • Gelatin sponge
  • Ophthalmic artery
  • Orbital exenteration
  • Orbital tumor
  • Spongel
  • Transarterial embolization

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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