Mahyuddin Mutmainah, Theresia Kania, Anggraini Neni, Subekti H Imam
Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia - Cipto Mangunkusumo Kirana Eye Hospital, Jakarta, Indonesia.
Department Internal Medicine, Faculty of Medicine, Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Oman J Ophthalmol. 2022 Mar 2;15(1):85-88. doi: 10.4103/ojo.ojo_76_21. eCollection 2022 Jan-Apr.
Thyroid carcinoma rarely metastasizes to the orbit. Approximately only 2%-7% of orbital metastatic lesion were found originally from thyroid carcinoma. We present three cases to increase the awareness of orbital metastases as the initial manifestation of thyroid carcinoma. Three female patients aged 28-65 years old presented with initial complaint of orbital mass. Further examination discovered an asymptomatic lump on every patient's neck. However, one patient was unaware of her lump. Examination revealed that all lesions were metastases from papillary thyroid carcinoma. These cases conclude several similarities. First, prominent unilateral proptosis, orbital mass in the superior quadrant, limited eyeball movement, and orbital bone destruction were found in every patient. Second, all the orbital computed tomography scan showed extraconal solid masses involving adjacent structures and expanding intra-cranially or intrasinusly. These findings should raise one's suspicion of a metastatic lesion primarily caused by thyroid carcinoma. Despite the rarity of orbital metastases, thyroid carcinoma must be considered as a potential primary tumor in patients with initial presentation of orbital mass. Thorough physical examination is important to determine the origin of metastases.
甲状腺癌很少转移至眼眶。最初发现的眼眶转移性病变中，约仅有2%-7%源自甲状腺癌。我们报告三例病例，以提高对眼眶转移作为甲状腺癌初始表现的认识。三名年龄在28至65岁的女性患者最初主诉为眼眶肿物。进一步检查发现每位患者颈部均有无症状肿块。然而，有一名患者未意识到自己有肿块。检查显示所有病变均为甲状腺乳头状癌转移所致。这些病例有几个相似之处。首先，每位患者均出现明显的单侧眼球突出、上象限眼眶肿物、眼球活动受限以及眼眶骨质破坏。其次，所有眼眶计算机断层扫描均显示眶锥外实性肿块累及相邻结构，并向颅内或鼻窦内扩展。这些发现应引起人们对主要由甲状腺癌引起的转移性病变的怀疑。尽管眼眶转移罕见，但对于以眼眶肿物为初始表现的患者，必须将甲状腺癌视为潜在的原发肿瘤。全面的体格检查对于确定转移灶的起源很重要。
