Clinical and instrumental diagnostics in patients with orbital metastasis

Abstract

PurposeTo analyze the data of clinical and instrumental features of patients with metastatic lesions of the orbit.Methods26 patients (21 women and 5 men) with orbital metastasis aged from 42 to 84 years (mean – 57.3 ± 11.2) were examined and treated in our department in the period from 2009 to 2014. All patients underwent a complete clinical and instrumental examination including CT (MRI) and ultrasound. Metastatic orbital lesions were confirmed morphologically (23 patients) and cytologically (3 patients).ResultsA unilateral lesion of the orbit was found in 21 patients, bilateral – in 5 patients. 19 patients had a history of cancer before orbital symptoms appeared, in 3 patients – orbital symptoms preceded the identification of the primary tumor, in one patient – simultaneously with the primary focus (uveal melanoma with extraocular growth and metastasis to the contralateral orbit). According to CT and US data in 23 patients there were detected diffuse tissue with extraocular muscles involvement. The lesions mostly localized in the central and lower parts of the orbit (17 patients), rare – in the upper and outer (9 patients). Destructive changes in the orbital walls (by CT) revealed only in 4 patients. According to histogenesis the epithelial metastatic tumors were prevailed: breast cancer – in 13, gastric cancer – 3, kidney cancer – 2, thyroid cancer – 2, cancer of the uterus – 1; bowel leiomyosarcoma – in 1, uveal melanoma – in 1 patient. In 3 patients (11.5%) with morphologically confirmed metastatic cancer of the orbit the nature of the primary lesion was not identified.ConclusionsBreast cancer is most common in development of metastatic tumors. Medical history data, clinical and instrumental findings are informative to suggest malignancy in orbit, requiring the need for morphological verification of the diagnosis for adequate therapy.