Clinical analysis of orbital metastasis from nasopharyngeal carcinoma

Abstract

Metastasis of nasopharyngeal carcinoma (NPC) to the orbit has been rarely known. We report 11 patients with metastasis of NPC to the orbit and discuss their clinical characteristics and prognosis. Eleven patients with orbital metastasis of NPC who were seen between January 1, 1991 and December 31, 2003 in Zhongshan Ophthalmic Center, Sun Yat-sen University, were retrospectively reviewed. Among 11 patients, there were nine males and two females. The mean age at diagnosis was 45.5 years. The left eye was involved in ten cases, and right eye in one. There were seven patients with a known history of NPC and four with no NPC history at the time of presentation. The seven patients with NPC history developed orbital metastasis at a mean time of 12.7 months (range 2.0 - 60.0 months) after the diagnosis of NPC. The mean duration of eye lesions at presentation was 10.3 months (range 0.7 - 36.0 months). Nine patients developed single metastatic focus and two patients had two foci in the affected orbit. The main component of the tumor was located in the nasal part of the orbit in eight cases, in the temporal part in two, and in the orbital apex in one. The anterior part of the orbit was affected in eight cases. The neoplasm was resected completely or partly through surgery. The diagnosis was histopathologically confirmed as NPC. Among them, four cases were squamous cell carcinomas, two cases lymphoepitheliomas, and five cases unclassified carcinomas. At the last following up examination, five patients had died as a result of disseminated metastasis, one patient had died of unknown cause and three were still alive with no active metastasis. Two patients had lost follow-up. The mean survival time after orbital diagnosis was 21 months. NPC with orbital metastasis is rare. However, it is the most common primary cancer metastasizing to the orbit in our Center. Most of them were located in the anterior nasal part of the orbit. The prognosis of these metastasis cases is very poor.