[Diagnosis and management of orbital metastatic tumors]

To evaluate the type, clinical features and diagnostic methods of orbital metastatic tumors.

In a retrospective study, the records of 30 consecutive cases with orbital metastatic tumors as confirmed by pathologic examination were analyzed with special attention to the epidemiology, clinical manifestations and imaging findings.

Most orbital metastatic tumors in China originated from the breast, followed, in order, by the lung and liver. The metastatic tumors of the orbit most frequently originated from the liver and lung in males, and from the breast and lung in females. The male or female ratio of patients with orbital metastasis was 1:1. The orbital metastases were more common in the children and the elderly. In 50% of patients, the orbital symptoms were the first signs of the disease. The longest course was seen in metastasis from the breast and the shortest from various types of blastomas. Orbital metastases could occur unilaterally or bilaterally. The most common symptoms of orbital metastatic tumors included diplopia and orbital pain. The signs included proptosis, limited ocular movement and increased intraorbital pressure. Based on the images of computed tomography or magnetic resonance imaging, orbital metastatic tumors could be divided into four different types according to the location and morphology of the tumors. Follow-up results revealed that 60% of orbital metastasis had poor prognosis.

The spectrum of orbital metastatic tumors in China is different from that in western countries. Familiarity with the clinical manifestation and diagnostic methods of orbital metastatic tumors can be helpful to relief the ocular symptoms and prolong the life of patients.