Related Experiment Video
Updated: May 10, 2026
06:51
The Modified Temptation Resistance Task: A Paradigm to Elicit Children's Strategic Lie-telling
Published on: April 6, 2018
Truth under a masquerade!
Sarita R J Gonsalves1, Geover Joslen Lobo, Norman Mendonca
1Department of Ophthalmology, Kasturba Medical College, Manipal, Karnataka, India. gonsalvessarita@gmail.com
BMJ Case Reports
|July 4, 2013
Summary
Bilateral orbital cellulitis, characterized by swelling and bulging eyes, can be an early indicator of widespread cancer metastasis in patients with a history of treated malignancies. This rare presentation highlights the importance of thorough investigation in recurrent or metastatic disease.
Area of Science:
- Oncology
- Ophthalmology
- Medical Imaging
Background:
- A 32-year-old woman with a history of treated rectal adenocarcinoma presented with acute bilateral periorbital edema.
- The patient had undergone surgery and chemotherapy six months prior, with initial negative metastasis workup.
Observation:
- The patient rapidly developed bilateral axial proptosis, chemosis, and diminished vision within a week.
- Examination revealed sluggish pupillary reactions and restricted extraocular movements. Systemic examination indicated poor nutritional status with elevated inflammatory markers.
Findings:
- Computed tomography (CT) of the orbit and brain confirmed metastasis to the frontal bones and orbits.
- Further investigations revealed concurrent liver and lung metastasis.
Implications:
- This case underscores that bilateral orbital cellulitis can be an unusual presenting sign of systemic metastasis in patients with previously treated malignancies.
- Prompt recognition and investigation are crucial for identifying advanced metastatic disease, even with seemingly localized symptoms.
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