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Disease&Treatment/Oculoplastics
Metastatic orbital tumor Breast cancer, lung cancer, prostate cancer Invasion of extraocular muscles, proptosis, diplopia, pain
eye_doc 2025. 4. 22. 00:04
👁 “Metastatic Orbital Tumors – Clinical Clues and Imaging Insights”
Metastasis to the orbit occurs in about 2–4% of cancer patients,
accounting for 1–3% of all orbital tumors.
All metastases reach the orbit via hematogenous spread, as the orbit lacks lymphatic channels.
Most often, it reflects advanced systemic malignancy and carries a poor prognosis.
🧠 Summary Table – Metastatic Orbital Tumors
FeatureDescription
| Common Primary Sites | |
| – Breast cancer (40–70%) | |
| – Lung, prostate, melanoma | |
| Spread Mechanism | Hematogenous (no lymphatics) |
| Frequent Symptoms | |
| – Proptosis, diplopia, pain | |
| – Extraocular muscle palsy, enophthalmos | |
| Muscle Involvement | |
| – Usually single EOM (medial or lateral rectus) | |
| – Often involves muscle belly to tendon | |
| Imaging (CT/MRI) | |
| – Focal enhancement, soft tissue mass | |
| – May involve bone and orbital apex | |
| – Rarely >10mm in size | |
| Differential Diagnosis | |
| – Thyroid orbitopathy, orbital pseudotumor | |
| – Lymphoma, trauma-related displacement | |
| Biopsy | |
| – Confirm via excisional or fine-needle aspiration biopsy (FNAB) | |
| Prognosis | |
| – Poor overall: mean survival ~15 months | |
| – Treatment focused on palliation and vision preservation |
✅ Clinical Insight
– Late-onset diplopia + prior cancer history = suspect orbital metastasis
– EOM enlargement alone is nonspecific → confirm with imaging and biopsy