Orbital Metastatic Tumors Difficult Diagnostic Situations

Abstract

Grishina Elena

Introduction: Orbital metastases compose about 15% of all orbital malignant tumors. If a cancer patient has got some orbital lesion everyone thinks about orbital metastasis. But a cancer patient sometimes has other orbital tumors or inflammatory orbital lesions. The aim of the work is to identify distinctive features of the orbit metastatic tumor for differential diagnosis with other tumors and inflammatory lesions in the orbit. Material and Methods: Retrospective, non-comparative, chart review of 81cancer patients. 74 patients (10 men and 64 women aged 18 – 87 years old, median 45 years old) had orbital metastases, 5 patients had the second malignant orbital tumor - primarily multiple malignant tumors (1 man and 4 women aged 55 – 78 years old, median 61 years old), and 2 men (64, 66 years old accordingly) had inflammatory orbital lesions. All the patients underwent complete ophthalmological and general examination. The orbital lesions were studied morphologically. Results: Distinctive features of the orbit metastatic tumor are the following: not rapid but gradual development of symptoms. As a rule there is a single well-delimited tumor in the orbit. Metastatic tumor is mainly localized under the upper wall of the orbit in the anterior or middle part of the orbit. Due to the localization of the tumor, exophthalmoses develop with displacement of the eyeball (mechanical strabismus). The main symptom of the orbital metastases is the limitation of the eye movements. The symptoms of orbital non-Hodgkin’s lymphoma are identical to the symptoms of orbital metastases. Acute orbital Inflammation, simulating metastases, had atypical erased symptoms. Conclusion: Only a comprehensive assessment of anamnesis data, clinical symptoms and the results of morphological examination of biopsy sample allows establishing the correct diagnosis of the orbital metastatic tumor. Palliative treatment of orbital metastases improves the quality of life of cancer patients.

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