Presentation of Orbital Metastases.

Area of Science:

• Ophthalmology
• Oncology
• Radiology

Background:

• Orbital metastases represent secondary spread of cancer to the orbit.
• Understanding the clinical characteristics of orbital metastases is crucial for diagnosis and management.

Purpose of the Study:

• To compare clinical features of patients diagnosed with orbital metastases, differentiating between those with a previously known systemic malignancy and those without.
• To identify common primary cancer types and their presentation patterns in the orbit.

Main Methods:

• Retrospective review of case notes and imaging for 159 patients with orbital metastases diagnosed between 1980 and 2022.
• Patients were categorized into two groups: Group I (known malignancy at orbital presentation) and Group II (unknown malignancy at orbital presentation).

Main Results:

• Breast cancer (48%) was the most frequent primary tumor, followed by neuroendocrine tumors (10%) and melanoma (7%).
• Group I patients (known primary) were more likely to be female, have breast or melanoma metastases, and present with posterior orbital involvement compared to Group II.
• Orbital metastases presented as distinct masses in 74% of cases, with breast cancer often showing infiltrative patterns.

Conclusions:

• Breast cancer, neuroendocrine tumors, and melanoma are the most common origins of orbital metastases.
• Approximately one-third of orbital metastases are diagnosed before the primary systemic malignancy.
• Clinical presentation and imaging findings can differ based on whether the primary tumor is known at the time of orbital metastasis diagnosis.