Abstract

Thyroid-associated orbitopathy is characterised on cross-sectional imaging by symmetric extraocular muscle enlargement sparing the musculotendinous junction. We report a case of this imaging finding in a biochemically euthyroid patient with metastatic squamous cell carcinoma of the lung undiagnosed at time of presentation.

Highlights

  • Clinical presentation A 63-year-old male presented to the emergency department with an acute episode of blurry vision and two months of headache and intermittent nausea

  • Symmetric enlargement of all the extraocular muscles with sparing of the myotendinous junctions is a typical feature of Graves disease.[1]

  • Exophthalmos associated with primary lung malignancy, none to date have been associated with the CT and MRI orbital findings demonstrated in the current case.[2,3]

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Summary

Kim and Lock

Primary right middle lobe malignancy with surrounding likely radiotherapy-related changes (Figure 4). Lymphadenopathy, the absence of new metastatic disease and near complete resolution of the extraocular muscle enlargement (Figure 5)

Discussion
Learning points

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