Edit concept Question Editor Create issue ticket

Orbital Metastasis

Metastatic Neoplasm to the Orbit


Presentation

  • To describe a rare orbital metastasis with atypical presentation. Retrospective case report.[ncbi.nlm.nih.gov]
  • Hepatocellular carcinoma is one of the commonest malignancies in Nigeria, however metastasis to the orbit is a rare presentation. To present a rare case of orbital metastasis of hepatocellular carcinoma.[ncbi.nlm.nih.gov]
  • Four patients presented with recent onset of unilateral proptosis, 1 patient presented with inflammatory manifestations, and 1 patient presented with unilateral ptosis. Pain was present in 4 patients.[ncbi.nlm.nih.gov]
  • We describe 1 patient with an orbital metastasis from prostate carcinoma presenting with proptosis and give details of his presentation, diagnostic tools, and treatment. This is a rare case.[ncbi.nlm.nih.gov]
  • To present the case of a radioiodine therapy-naïve thyroid cancer patient with postthyroidectomy diplopia. A 63-year-old male patient presented with goiter. Histology performed after thyroidectomy proved follicular thyroid cancer.[ncbi.nlm.nih.gov]
Familial Adenomatous Polyposis
  • This may be associated with familial adenomatous polyposis and hereditary non-polyposis colorectal cancer (Lynch) syndrome. Metastatic tumors to the orbit are rare and most commonly are from lung, breast, prostate, and kidney primaries.[jcmtjournal.com]
Ascitic Fluid
  • The histopathologic characteristics of the carcinoma in the orbit and ascites fluid combined with the immunophenotypic features helped determine the primary site of the malignancy.[ncbi.nlm.nih.gov]
Soft Tissue Swelling
  • He underwent MRI of brain and orbit revealed a soft tissue swelling inthe left infratemporal fossa measuring 5.2x4 cm. It was extended medially and infiltrated the left orbit and its bony lateral wall besides the lateral rectus muscle (Fig. 3).[ijp.iranpath.org]
Rectal Mass
  • On colonoscopy, there was an elevated irregular rectal mass 3.5 cm above the anal verge. Histopathology showed irregular distorted glands lined by highly dysplastic glandular cells with severe atypia and mitosis.[ijp.iranpath.org]
Rectal Bleeding
  • Case report A A 62-year male patient from tribal region in West Bengal, India was attended to Surgery Out Patient Department in 2015 with complaints of irregular bowel habit and occasional rectal bleeding for last two months.[ijp.iranpath.org]
Xanthelasma
  • Lobular carcinoma has been noted to metastasize to the eyelid where it exhibits a foamy cytoplasmic appearance mimicking histiocytes, leading to confusion with the benign entity of xanthelasma. 4 Van der Heijden et al 5 reported a case of lobular carcinoma[jamanetwork.com]
Shoulder Pain
  • Abstract A 63-year old male with chronic shoulder pain and painful left eye with binocular diplopia of sudden onset was seen independently by Ophthalmologists and his family Doctor and investigated first non-invasively where masses were found both in[ncbi.nlm.nih.gov]
Diplopia
  • This case showed that retro-orbital metastasis should be considered as a differential diagnosis in a patient with thyroid cancer who presents with unilateral diplopia.[ncbi.nlm.nih.gov]
  • Abstract A 63-year old male with chronic shoulder pain and painful left eye with binocular diplopia of sudden onset was seen independently by Ophthalmologists and his family Doctor and investigated first non-invasively where masses were found both in[ncbi.nlm.nih.gov]
  • The occurrence of progressive enophthalmos can represent an unusual symptom of orbital metastasis, commonly presenting with proptosis and diplopia.[ncbi.nlm.nih.gov]
  • Without 131 I therapy, diplopia occurred from metastasis to the right medial rectus muscle. Improvement followed after one therapy dose of 131 I.[karger.com]
  • A 66-year-old man presented with a 3-week history of right eye pain and diplopia. He also reported a 4- to 5-month history of urinary frequency, hematuria, and passing gray-white particles in his urine.[archivesofpathology.org]
Strabismus
  • Diplopia (48%), pain (42%), and visual loss (30%) were the commonest symptoms at presentation; whereas proptosis (63%), strabismus (62%), and visual loss (41%) were the most frequent clinical signs.[ncbi.nlm.nih.gov]
  • Paraneoplastic neurologic findings including cerebellar ataxia or opsoclonus/myoclonus (dancing eyes, dancing feet) may occur. 5 Other manifestations include Horner's syndrome, aniscoria, and strabismus. 2 Ophthalmic involvement by definition is Stage[nature.com]
  • J Pediatr Ophthalmol Strabismus 2007;44:106-11. [ PUBMED ] 2. Volpe NJ, Jakobiec FA. Pediatric Orbital tumors. Int Ophthalmol Clin 1992;32:201-21. [ PUBMED ] 3. Shields JA, Shields CL. Rhabdomyosarcoma: review for the ophthalmologist.[ojoonline.org]
  • The most common presenting signs and symptoms included diplopia with noncomitant strabismus, proptosis, and a palpable mass. In nine cases (26%), the orbital metastasis was detected in patients with no prior history of cancer.[ncbi.nlm.nih.gov]
Unilateral Proptosis
  • A 44-year-old man presented with unilateral proptosis and progressively deteriorating vision of his left eye over a 2-week period.[ncbi.nlm.nih.gov]
  • An otherwise asymptomatic 63-year-old woman with a history of a carcinoid tumor of the ileum and a cutaneous melanoma of the shoulder developed unilateral proptosis.[ncbi.nlm.nih.gov]
  • Four patients presented with recent onset of unilateral proptosis, 1 patient presented with inflammatory manifestations, and 1 patient presented with unilateral ptosis. Pain was present in 4 patients.[ncbi.nlm.nih.gov]
  • Unilateral proptosis as a manifestation of orbital metastasis from follicular thyroid cancer is rarely reported.[medcraveonline.com]
  • Basu S, Nair N, Aravind N: Unilateral proptosis with thyrotoxicosis resulting from solitary retroorbital soft tissue metastasis from follicular carcinoma thyroid. Clin Nucl Med 2001;26:136–138. Henderson JW: Orbital Tumors, ed 3.[karger.com]
Eye Pain
  • A 66-year-old man presented with a 3-week history of right eye pain and diplopia. He also reported a 4- to 5-month history of urinary frequency, hematuria, and passing gray-white particles in his urine.[archivesofpathology.org]
  • On initial presentation, her eye pain and mass was attributed to ocular sarcoidosis.[ascopubs.org]
  • Figure 27 Breast cancer metastasis in a 56-year-old woman who presented with eye pain. Axial postcontrast T1-weighted fat-suppressed MR image shows thickening of the left lateral rectus muscle (arrows), with involvement of the tendinous insertion.[pubs.rsna.org]
Unilateral Ptosis
  • Four patients presented with recent onset of unilateral proptosis, 1 patient presented with inflammatory manifestations, and 1 patient presented with unilateral ptosis. Pain was present in 4 patients.[ncbi.nlm.nih.gov]
Neck Swelling
  • Case Report In February 1995 a 63-year-old euthyroid male patient reported a neck swelling of 15 days’ duration. Palpable nodules were found within both lobes of the thyroid gland but no cervical lymph nodes.[karger.com]
Focal Neurologic Deficit
  • No focal neurological deficit was noted. CT scan of the skull, soft tissues, and brain showed a mixed density mass along the lateral wall of the left retro-orbital area, adherent to the optic nerve [Figure 2].[jcmtjournal.com]
  • No focal neurological deficit was noted. CT scan of the skull, soft tissues, and brain showed a mixed density mass along the lateral wall of the left retro-orbital area, adherent to the optic nerve [Figure 2] .[jcmtjournal.com]
Frontal Headache
  • An 82-year-old man presented with progressive right frontal headaches. The patient's history was significant for benign polyps on surveillance colonoscopy 2 years prior, without high-grade dysplasia or carcinoma.[ncbi.nlm.nih.gov]

Workup

  • It is recommended that any patient with visual symptoms and known urothelial cancer should undergo expedited workup for metastatic disease.[urotoday.com]
  • Workup revealed type Ⅲ advanced gastric cancer at the lesser curvature of the gastric antrum. Biopsy revealed a diagnosis of poorly differentiated adenocarcinoma.[dear-medic.jp]
  • The workup of suspected metastatic scirrhous breast cancer to the orbit includes a complete history and physical, imaging of the orbit (CT or MRI), mammogram, orbital mass biopsy and body imaging for metastatic disease.[webeye.ophth.uiowa.edu]
  • A diagnosis of a giant basal cell carcinoma metastatic to the lungs was established;the patient had an ECOG performance status of 2, a blood workup showed he had normal renal function. Platinum based chemotherapy was decided.[panafrican-med-journal.com]
  • Diagnosis, Workup and Treatment Laboratory blood work was sent, including TSH, T3, free T4 and thyroid stimulating immunoglobulin, which all came back within normal limits. The patient underwent further imaging to characterize the orbit pathology.[reviewofophthalmology.com]

Treatment

  • Radiotherapy remains an efficacious modality for treatment of orbital metastases.[ncbi.nlm.nih.gov]
  • The treatment of prostate orbital metastases is also reviewed.[ncbi.nlm.nih.gov]
  • The treatment consisted of concomitant radiochemotherapy. The evolution didn't revealed recurrence of the disease after 18 months.[ncbi.nlm.nih.gov]
  • Abstract Non-pulmonary metastases in osteosarcoma are increasingly recognized because of improved longevity in patients receiving modern treatment. One rare site of metastasis is the orbit, with only three cases reported so far.[ncbi.nlm.nih.gov]
  • Radical cystectomy with ileal conduit diversion remains the standard treatment for invasive bladder cancer.[ncbi.nlm.nih.gov]

Prognosis

  • Orbital metastasis of urinary bladder carcinoma is associated with a poor prognosis and is more frequently observed in older people. In addition, it is five times more prevalent in men than in women.[ncbi.nlm.nih.gov]
  • It usually indicates extensive haematogenous dissemination of a primary cancer and is associated with poor prognosis. Breast, lungs and prostate cancers are the most common primary cancers leading to orbital metastasis.[ncbi.nlm.nih.gov]
  • The prognosis is grim, and with the exception of rare cases secondary to hormone-responsive tumors, the majority of patients succumb to their disease within a year of diagnosis.[ncbi.nlm.nih.gov]
  • Regardless of the primary tumor, the prognosis following orbital metastasis is poor. It is important to consider radiologic investigation when patients with systemic malignancy present with unexplained headache.[ncbi.nlm.nih.gov]
  • T1: isointense to muscle 8 T2: hyperintense to muscle, hypointense to fat T1 C (Gd): enhancement present but variable Treatment and prognosis Treatment is primarily with radiotherapy, typically with a total dose of 30-40 Gy 1 .[radiopaedia.org]

Etiology

  • Systemic history and orbital imaging play an important role in differentiating the infective etiology from metastasis.[sjopthal.net]
  • […] between the ages of 15 and 35 years, with a slightly higher incidence in women. 3 Although multiple predisposing factors have been identified such as genetic diseases, radiation exposure, certain chemical agents, lymphedema, and trauma, no specific etiology[mdmag.com]
  • MacFaul stated in his “System of ophthalmology” that unlike exophthalmos , enophthalmos could not lead to a fatal outcome [ 7 ]; because his classification failed to mention orbital tumors as a possible etiology.[bmcpediatr.biomedcentral.com]
  • Disease Orbital Cellulitis (ICD-9 #376.01) Etiology Orbital cellulitis most commonly occurs when bacterial infection spreads from the paranasal sinuses, most often from the ethmoid sinus through the thin lamina papyracea of the medial orbital wall.[eyewiki.aao.org]
  • The etiology of breast cancer metastasis to the head and neck region is largely unknown.[journals.lww.com]

Epidemiology

  • INTRODUCTION According to Surveillance, Epidemiology, and End Results data, the incidence of hepatocellular carcinoma (HCC) has been steadily increasing since the mid-1980s and thus presents an increasing health problem in the United States.[wjgnet.com]
  • American journal of epidemiology , 155(4): 323-31 [ CR ] [ PM ] [ EČ ][ GS ] Fan, Z., Rijn, M., Montgomery, K., Rouse, R.V. (2003) Hep par 1 antibody stain for the differential diagnosis of hepatocellular carcinoma: 676 tumors tested using tissue microarrays[scindeks.ceon.rs]
  • Prostate cancer epidemiology. Lancet 2003;361:859-64. [Figure 1] , [Figure 2] , [Figure 3] This article has been cited by 1 Unilateral exophthalmos revealing metastatic prostate cancer El Yazami Adli, O., Elammari, J.E., Elfassi, M.J., Farih, M.H.[indianjcancer.com]
  • Diagnosis: Enophthalmos Secondary to Metastatic Scirrhous Breast Cancer to the Orbit Epidemiology Less than 20% of patients with enophthalmos (Cline) 76% of enophthalmos due to metastasis Signs Enophthalmos Impaired motility Ptosis Impaired levator function[webeye.ophth.uiowa.edu]
Sex distribution
Age distribution

Pathophysiology

  • The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders. Psychoneuroendocrinology, 25(1), 1-35. ‎ Pagina 52 - In: Wall PD, Melzack R (eds), Textbook of pain. Churchill Livingstone, Edinburgh... ‎[books.google.it]
  • Pathophysiology Orbital cellulitis most commonly occurs in the setting of an upper respiratory or sinus infection. The human upper respiratory tract is normally colonized with Strep pneumoniae and infection can occur through several mechanisms.[eyewiki.aao.org]
  • Sleisenger and Fordtran’s gastrointestinal and liver disease: pathophysiology, diagnosis, management. 9th Ed. Philadelphia (PA): Saunders/Elsevier; 2010. 2. Kong BD, Lee TW. Clinical analysis of metastatic intraocular malignancy.[e-ce.org]
  • Types of invasive breast carcinoma include ductal, lobular, and mixed. [5] Pathophysiology To date, the basis for breast carcinoma as the most common primary metastatic process to the orbit is unclear.[eyewiki.aao.org]

Prevention

  • The clear margins may prevent local recurrence, but they do not prevent micro-metastasis to lymph nodes or distant organs via the blood stream.[ojoonline.org]
  • The remaining two patients were capable of being diagnosed early, and immediate radiotherapy for their tumors provided dramatic symptomatic remission and long-term prevention of recurrence of symptoms.[ci.nii.ac.jp]
  • Prevention of bone loss with alendronate in postmenopausal women under 60 years of age. ‎ Pagina 74 - Heim, C".., Ehlert, U., & Hellhammer, DH (2000). The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders.[books.google.it]
  • Primary prevention Identifying patients and effectively treating upper respiratory or sinus infections before they evolve into orbital cellulitis is an important aspect of preventing preseptal cellulitis from progressing to orbital cellulitis.[eyewiki.aao.org]
  • […] a case of giant basal cell carcinoma metastaticin lung occurringin a 79 years old male patient, with a fatal evolution after one course of systemic chemotherapy.Giant basal cell carcinoma is a very rare entity, early detection of these tumors could prevent[panafrican-med-journal.com]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!