A 32-year-old male with colonic neoplasia with liver, retroperitoneal and mediastinal metastases, with a rapid evolution over a background of ulcerative colitis.
One week after diagnosis, despite presenting an advanced stage, the patient was admitted for surgical intervention with partial tumor resection. Postoperative chemotherapy was initiated with different consecutive therapeutic lines oxaliplatin + foxaliplatin + foxacillin.
The K-ras gene was even determined for possible treatment with cetuximab or panitumumab, being negative, and therefore ruling out this therapeutic alternative.
Moreover, treatment with beizumab is not advisable because it drains into the abdominal cavity, producing purulent material.
Fifteen days after surgery, the patient complained of moderate left eye pain, so they requested a consultation in our service.
A, but above all, there is moderate lateral edema of the conjunctival motility, severe non-reducible exophthalmos, complete ptosis in the left eye, and limitation of eye gaze in all cases
Cranial and orbital magnetic resonance imaging (MRI) with T1-weighted images and diffusion-weighted axial and FLAIR images were requested.
Two nodular lesions are observed in the left orbita, one of them 2×1cm, located in the upper region, affecting the upper rectus muscles and elevator of the eyelid highly suggestive of metastasis to the second rectum.
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Due to the patient's poor general condition, radiotherapy was ruled out and methylprednisolone boluses were initiated at a dose of 1g/day, with partial pain relief.
However, 48 hours after the second bolus of corticosteroid therapy, the patient developed extreme abdominal and ocular pain, so sedation was decided and the patient died.
