Abstract ID: 26-170
Rare case of orbital metastasis from lung cancer
Author: Ameerah Ilyas Base Hospital / Institution: Newcastle NHS trust
Presentation Type: ePoster Presentation
Purpose
Orbital metastasis from lung cancer remains a rare entity and the early signs of its manifestation are vital to ensure prompt treatment and prevent rapid deterioration. This study aims to show the early manifestations of orbital metastasis to ensure prompt treatment.
Methods
A 48 year old male reported non-specific symptoms of chemosis and irritation of the right eye with a background of poorly differentiated malignancy with multiple areas of metastases. conjunctival Optical Coherence Tomography (OCT) showed hyperdense solid lesions with cystic changes inside the lesion and surface. Initial differentials included increased episcleral venous pressure from intracranial metastases or conjunctival metastases. The patient was started on anti-inflammatory and steroid eye drops with follow up for further investigation once the inflammation had settled. Prior to the appointment, the patient re-presented in eye casualty with proptosis and early signs of right optic neuropathy.
Results
The patient was already receiving chemotherapy under the oncology team and oral steroids for oedema as a result of his brain metastases. The visual acuity declined from 6/24 to 6/60 in a matter of weeks with marked restriction of ocular motility. Hertel exophthalmometry showed 21mm in the right eye and 16mm on left with an intracanthal distance of 112 mm. CT orbits showed a rapidly enlarging right orbital tumor in the medial part of the orbit. The patient was in discussion for radiotherapy and possible orbital exenteration depending on systemic outcomes. Patient remains under review.
Conclusion
The case demonstrates the importance of considering possible paraneoplastic in patients with non-specific symptoms of a red eye and the rapid deterioration of such cases in a short time frame. The involvement of the oncology team early on is vital to explore the full range of options in management and reduce the likelihood of threatened vision loss. It also adds to the limited literature on such cases.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Ahmed | Hussien | Newcastle NHS trust |