Abstract
Orbital metastasis from lung cancer as an initial presenting symptom is a rare entity, which may paradoxically delay the diagnosis and initiation of correct management, due to the confusion of it being primary orbital pathology. Herein we report a case of a 58 year old woman, who presented with painful orbital swelling along with diminution in her vision. The patient was initially thought to have a primary eye lesion; however chest X-ray was suggestive of a lung mass, which was confirmed by chest computed topography followed by ultrasound guided fine needle aspiration cytology. The patient was then referred to a cancer centre for further management. This case report aims to increase the knowledge about this metastasis as a probable cause of orbital symptoms in certain subsets of patients, so that correct therapeutic decisions may be made in the future.
Highlights
Orbital metastatis as the initial presenting symptom from a metastatic lung lesion is a rare entity, occurring at an incidence of approximately 7%1,2
Poor management increases the odds of progressing the tumor stage. We report one such case in a 58 year old woman, who presented with unilateral peri-orbital swelling and diminution of vision
Symptoms related to orbital metastasis presents earlier to that of the primary lesion in around 20% of patients[2]
Summary
Orbital metastatis as the initial presenting symptom from a metastatic lung lesion is a rare entity, occurring at an incidence of approximately 7%1,2 This should be kept as one of the differentials in any patients presenting with orbital symptoms, so as to frame an accurate and effective plan of management. The patient was started on a steroid therapy (injection dexamethasone at 8mg stat followed by 4 mg every eight hours), which decreased the swelling on the patient’s eye and improved visual acuity to finger counting within a period of 1 week. This further hinted at compressive rather than infiltrative effect on the optic nerve by the lesion. Even a small delay may have had a disastrous impact on the outcome of the vision in the patient
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