Clinical and imaging characteristics of orbital metastatic lesions among Egyptian patients
Received 2 May 2015
Accepted for publication 4 July 2015
Published 10 September 2015 Volume 2015:9 Pages 1683—1687
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Mohammed A Eldesouky, Molham A Elbakary
Oculoplastic Unit, Faculty of Medicine, Tanta University, Tanta, Egypt
Purpose: The aim of the study was to review the demographic, clinical, and imaging features of Egyptian patients with orbital metastases.
Methods: The study was a retrospective study of patients with orbital metastatic lesions over the last 15 years.
Results: The study included 37 patients. Male patients represented 54.1%. The primary tumor was breast carcinoma in 21.6% of patients, with hepatocellular carcinoma (HCC) in 16.2% and cutaneous malignant melanoma in 13.5% of patients. Bronchogenic carcinoma, prostatic carcinoma, and thyroid adenocarcinoma was the primary tumor in 8.1% of cases each. The most common primary tumor in children was neuroblastoma (42.9% of pediatric patients). In 24.3% of patients, there was no history of cancer, and the orbital metastatic lesion was the first presentation of the disease. Proptosis and/or globe displacement was the presenting feature in 78.4%, followed by diplopia and limited ocular movements in 35.1%, inflammatory manifestations in 10.8%, and ptosis in 5.4%. In 54.1% the lesion involved the right orbit and in 5.4% bilateral involvement was found. Orbital imaging showed infiltrative lesion in 62.2%, mass lesion in 21.6%, isolated muscle thickening in 10.8%, and bone metastasis in 5.4%. All cases of HCC showed osteoclastic changes, and all cases of prostatic carcinoma were osteoblastic lesions.
Conclusion: Orbital metastasis from HCC represented a higher incidence when compared to previous studies, probably due to the increased incidence of HCC found in the Egyptian population. Orbital metastasis can display a variety of clinical and imaging features, and a high index of suspicion is required, as 24.3% showed negative history of cancer.
Keywords: orbital metastasis, orbital tumors, clinical features
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