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. 1997 May;81(5):386–390. doi: 10.1136/bjo.81.5.386

Orbital metastases: diagnosis and course

D Char 1, T Miller 1, S Kroll 1
PMCID: PMC1722195  PMID: 9227204

Abstract

AIMS—Three issues were investigated in adult outpatients with orbital metastases. One, how accurate are current diagnostic methods? Two, what is the survival associated with orbital metastases? Three, did any clinical factors correlate with prognosis in this patient cohort?
METHODS—Retrospective analysis of patients with orbital metastases managed in an ocular oncology unit.
RESULTS—11 of 31 (35%) patients had no known primary malignancy at the time of orbital diagnosis. In eight of 31 (26%) computed tomography and/or magnetic resonance imaging data did not yield the diagnosis of metastases. In 15 of 17 (88%) cases a fine needle aspiration biopsy was diagnostic. Several types of therapy were used. The median survival was 1.3 years.
CONCLUSION—Orbital metastases, even with newer diagnostic techniques can be difficult to diagnose. Management was based on location and extent of both orbital and systemic disease as well as vision. In most cases, orbital symptoms were palliated; however, survival was dismal. No clinical factor correlated with prognosis.



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Figure 1  .

Figure 1  

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Focal area of muscle enlargement is a typical radiological finding in some orbital metastases. This is noted on axial computed tomography.

Figure 2  .

Figure 2  

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Bony destruction contiguous to an orbital mass is a finding often seen orbital metastases in contrast with most benign orbital tumours. This is shown on a parasagittal computed tomography reconstruction.

Figure 3  .

Figure 3  

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In an older patient, diffuse intraconal lesions are commonly due to metastases. This axial magnetic resonance scan demonstrates diffuse infiltration of the intraconal area.

Figure 4  .

Figure 4  

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This axial T1 weighted magnetic resonance scan demonstrates a focal intraconal mass.

Figure 5  .

Figure 5  

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Kaplan-Meier curve of survival of patients with orbital metastases. The mean survival of patients with orbital metastases was 1.3 years; the 2 year survival rate was 27% (31 cases).

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