Isolated Orbital Metastasis in Occult Rectal Adenocarcinoma - A Case Report

Isolated Orbital Metastasis

Abstract

Introduction: Orbital metastasis is a rare disease, though it may be the first manifestation of a primary tumor in up to 30% of cases. In adults, metastasis is often from carcinoma breast, lung and melanoma. Case report: A 23 year old male developed swelling around the outer aspect of the right eye. Post operative histopathology stated the possibilities as small cell variant of osteogenic sarcoma or ewings sarcoma/PNET of the right eye. IHC favoured metastatic deposit of poorly differentiated adenocarcinoma. PET CT and Colonoscopy confirmed the diagnosis of carcinoma rectum. Bone scan revealed orbital metastasis.
Conclusion: Carcinoma of the rectum with orbital metastasis is a very rare presentation. However, we must consider this association in order to recognize the onset and administer appropriate treatment. The authors believe that this is a rare case and the first one reported with presentation first as an orbital metastasis with subsequent diagnosis of the occult primary.