Metastases of systemic malignancies to the orbit: a major review

Purpose: Due to improved survival durations and enhanced surveillance modalities, metastases of systemic malignancies to the orbit are increasing. This review is intended to discuss the epidemiologic, clinical, and management features of orbital metastases. Methods: A literature search for relevant publications on the topic was performed via PubMed, and the appropriate data were extracted from these manuscripts. Results: While rare, metastases to the orbit are regularly encountered in clinical practice. The overwhelming majority of these lesions present in adult patients, and metastatic disease may emerge several years after the diagnosis of the initial cancer. Subjectively, these lesions tend to present with complaints of diplopia, blurred vision, and pain, and objective signs tended to include vision loss, limitation of extraocular motility, proptosis, the presence of a palpable mass, and ptosis. Different studies reported a variety of primary tumors, although breast and lung malignancies were generally among the most common. A sizeable portion of patients may not have a known primary malignancy. After detection, survival rates are generally short, and metastatic disease suggests a worrisome prognosis. Radiation therapy may alleviate symptoms. Conclusions: Metastases of systemic disease present with specific subjective, clinical, and radiographic features. Furthermore, these lesions may present years after an initial diagnosis. Clinicians should be aware of the implications of this malady on patient survival and must consider interventions to improve quality of life.