Enophthalmos as a rare manifestation of metastatic orbital involvement

Two cases in which orbital metastasis produced enophthalmos, instead of the usual exophthalmos, are reported. Only fourteen other cases have been described previously and they are reviewed. At time of diagnosis of the enophthalmos, meningeal carcinomatosis coexisted in the first case and probably also in the second case. This association can lead to diagnostic errors with either the orbital metastasis or the meningeal carcinomatosis being missed. In addition, as in our second case, the enophthalmos can be the initial manifestation of cancer.