Pathology Spotlight – Metastatic sarcoma of the orbit

Sarcomas are a rare type of cancer that can develop almost anywhere in the body , because they arise in mesenchymal cells which occur all over the body– i.e. fat, cartilage, bone, muscle, vascular or the tissue in which blood cells arise.

GC 5378
Metastasis from thoracic mediastinal lymph nodes

This specimen is  a metastatic sarcoma of the right orbit and the surrounding skull. The course of the patient’s illness was typical for a tumour spreading or metastasising around the body. It started with complaints of a “sciatica” type of pain which spread to his back and shortly thereafter he found instability of his right knee when walking.  He lost weight and strength and six months before death a swelling appeared in his chest wall and enlarged glands in the right armpit and in his neck.  Four months later his right eye began to bulge outwards, indicating that the tumour had spread by metastasis to his orbit. Post-mortem examination showed the primary tumour to have arisen in his chest and had first spread to the right side of his lumbar spine and probably then to his orbit.  As is usual with metastasizing tumours, the cells of the secondary tumour were similar to the site of origin – in this case the lymph glands of the chest – rather than the site where the secondary growth occurs.

There are about 3800 new cases of sarcoma diagnosed in the UK each year, with about 3300 affecting soft tissue, as in this case, and 500 affecting bone. Within these groups there are around 100 different sub-types of sarcoma. Diagnosis tends to be at a younger age than most cancer patients, with 37% of people diagnosed with sarcoma being under 50. They are usually discovered after a patient finds a lump somewhere on their body.





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