Foo F Y, Lee M, Looi A
Singapore National Eye Centre, Singapore.
Orbit. 2010 Oct;29(5):262-5. doi: 10.3109/01676830.2010.485719. Epub 2010 Aug 12.
Although rare, orbital metastatic tumors may be the initial presentation of an asymptomatic primary carcinoma. We report a rare case, with clinicopathological correlation, of metastatic pancreatic adenocarcinoma, presenting first in the orbit with symptoms of diplopia, blurring of vision and supraorbital ache. Computed tomography and magnetic resonance imaging of the orbit showed a left solid intraconal tumor with peripheral rim enhancement. The tumor demonstrated hypointensity on both T1- and T2-weighted sequences. Excisional biopsy was performed and histopathology confirmed a metastatic adenocarcinoma. Subsequent gastrointestinal imaging and tumor markers revealed an asymptomatic pancreatic adenocarcinoma, with multiple liver metastases. Our patient developed hepatobiliary sepsis and passed away 44 days after diagnosis. This case highlights the role of early biopsy of atypical orbital tumors in the localization of an asymptomatic primary carcinoma.
尽管眼眶转移性肿瘤较为罕见，但可能是无症状原发性癌的首发表现。我们报告一例罕见的伴有临床病理相关性的转移性胰腺腺癌病例，该病例首先表现为眼眶症状，包括复视、视力模糊和眶上疼痛。眼眶计算机断层扫描和磁共振成像显示左侧锥内实性肿瘤，周边有强化。该肿瘤在T1加权和T2加权序列上均呈低信号。进行了切除活检，组织病理学证实为转移性腺癌。随后的胃肠道影像学检查和肿瘤标志物检查发现了无症状的胰腺腺癌，并伴有多处肝转移。我们的患者发生了肝胆败血症，诊断后44天去世。该病例突出了对非典型眼眶肿瘤进行早期活检在无症状原发性癌定位中的作用。
