Case report: Improving quality of life through hyaluronic acid-based fillers after orbital cancer treatment

Abstract

Background: Myoepithelial carcinoma is a very rare yet aggressive tumor in children. Surgical intervention and local radiotherapy often lead to post-therapy complications, affecting both the aesthetic and functional quality of life in survivors. Hyaluronic acid (HA) dermal fillers offer a minimally invasive option to improve the appearance and quality of life for these patients once they are declared tumor-free.

Case presentation: We present the case of an 18-year-old girl with a history of myoepithelial carcinoma in the right upper orbit, diagnosed at the age of 8. The patient underwent surgery to remove the tumor and lacrimal gland, followed by chemotherapy and radiotherapy. A complete response to treatment was achieved, and the patient was monitored with regular clinical and radiological exams for 5 years, after which she was declared tumor-free and followed for late effects of therapy. Post-surgical radiotherapy resulted in atrophy of the upper orbital frame and functional complications. The patient exhibited upper eyelid retraction, ptosis, continuous lacrimation, and conjunctival redness. Ten years after treatment, the patient underwent dermal filler injections using Aliaxin^® Essential Volume (A_EV) and Aliaxin^® Superior Volume (A_SV) to address the aesthetic impairment of the upper right orbit. A_SV was administered using a 22G x 50mm cannula on the periosteum of the superior orbital frame, entering from the outer canthus. A_EV was injected with a cannula into the muscle, also entering from the outer canthus. Before treatment, the patient exhibited upper eyelid retraction, ptosis, continuous lacrimation, and conjunctival redness. Following the injections, improvements were observed in all pre-treatment symptoms. The closing ability of the upper eyelid was restored, along with superior orbital volume and symmetry. Enhanced eyelid function improved eye hydration, reduced redness in the conjunctiva, and led to better vision and overall quality of life.

Conclusion: To our knowledge, this is the first reported case of using dermal fillers to treat ocular changes resulting from cancer treatment. Injections of A_EV and A_SV provided both aesthetic and functional improvements.

Keywords: aesthetic medicine; dermal filler; hyaluronic acid; myoepithelial carcinoma; post-surgical complication.

Figure 1

Schematic representation of injection technique. Cannula entry-point has been identified at the outer canthus of the eye and injection has been performed using a 22G x 50 mm cannula. A_SV has been applied on the periosteum of the superior orbital frame, while A_EV has been injected on the muscle layer.

Figure 2

Photographs of the patient: (A, B) before aesthetic treatment; (C) 1-month after treatment with Aliaxin^® Essential Volume and Aliaxin^® Superior Volume; (D) 14-months after treatment. Patient provided informed consent for the use of these images for scientific research.