Topic: ESOPRS 2021 ePoster sessions
Time: Sep 17, 2021 16:00 Amsterdam, Berlin, Rome, Stockholm, Vienna, 15:00 London
(plain text version here)
Paraneoplastic Orbital Syndrome: A Case Series of 11 Patients
Author: Agni Mokka
ePoster Number: 118,00
Purpose
Paraneoplastic orbital syndrome (POS) is a rare and often underrecognized manifestation of systemic malignancy, presenting with a spectrum of ocular and orbital findings. Early identification is critical for timely oncological management, yet diagnosis remains challenging due to its diverse clinical presentations. We aim to present and share our experience in diagnosing and managing 11 cases of POS, highlighting key clinical features, diagnostic challenges, and treatment outcomes.
Methods
We retrospectively reviewed 11 cases of POS diagnosed at our institution over the past 10 years. Patient demographics, clinical presentations, imaging findings, associated malignancies, and outcomes were analyzed.
Results
The cohort included 6 males and 5 females (mean age: 60 years). Presenting symptoms included periorbital pain (63%), proptosis (45%), ptosis-upper eyelid edema (36%), and diplopia (27%). CT orbits & MRI scans revealed orbital inflammation in 8 cases, extraocular muscle involvement in 73%, and orbital lesions in 2/11 of cases. 9 patients underwent PET-CT whole body scans for further detection and evaluation of primary or metastatic tumors. Orbital biopsies were performed in 5 patients, leading to the diagnosis of a metastatic tumor in 3 cases. Underlying malignancies included breast carcinoma (n=3), lymphoma (n=2), microcystic adnexal carcinoma (n=1), and thyroid carcinoma (n=1). POS preceded systemic malignancy diagnosis in 45% of cases. Immunotherapy or chemotherapy led to partial or complete resolution of symptoms in 54% of patients, while 4 patients received radiotherapy.
Conclusion
POS remains a diagnostic challenge, often mimicking other orbital inflammatory or neoplastic conditions. Clinicians should maintain a high index of suspicion, particularly in atypical orbital presentations with systemic symptoms. Multidisciplinary collaboration is essential for early malignancy detection and improved patient outcomes.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Hetvi | Bhatt | University Hospitals of Leicester |
| Awais | Rauf | University Hospitals of Leicester |
| Steven | Isherwood | University Hospitals of Leicester |
| Mary | Awad | University Hospitals of Leicester |
| Joyce | Burns | University Hospitals of Leicester |
| Antonella | Berry-Brincat | University Hospitals of Leicester |
| Raghavan | Sampath | University Hospitals of Leicester |
Abstract ID: 25-461
