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Orbital metastasis in advanced gallbladder and biliary tract malignancy
Aashray Singareddy1, George J Harocopos2, Steven M Couch3
1Division of Oncology, Washington University in St Louis, St. Louis, Missouri, USA a.singareddy@wustl.edu.
BMJ Case Reports
|July 20, 2025
Summary
Orbital metastasis is rare, but this case highlights gallbladder cancer presenting first as an eye mass. Early diagnosis via imaging and biopsy led to successful chemoimmunotherapy treatment.
Area of Science:
- Oncology
- Ophthalmology
- Medical Imaging
Background:
- Orbital metastases are uncommon, representing a rare manifestation of advanced cancer spread.
- Gallbladder and biliary tract cancers typically metastasize to the liver, lungs, or peritoneum.
Purpose of the Study:
- To report an unusual case of orbital metastasis from gallbladder and biliary tract cancer.
- To emphasize the importance of considering rare metastatic sites in cancer diagnosis.
Main Methods:
- Magnetic Resonance Imaging (MRI) of the orbit.
- Positron Emission Tomography (PET) scan for systemic staging.
- Tumor biopsy for histopathological confirmation.
Main Results:
- An orbital mass was the initial presenting sign of metastatic gallbladder and biliary tract cancer.
- Diagnosis was confirmed through a combination of MRI, PET, and biopsy.
- The patient responded well to initial chemoimmunotherapy, with tumor regression observed on follow-up imaging.
Conclusions:
- Orbital metastasis can be the first clinical manifestation of gallbladder and biliary tract cancer.
- Multimodality imaging and biopsy are crucial for diagnosing rare metastatic presentations.
- Chemoimmunotherapy shows promise in managing such advanced cases, with radiation potentially deferred.
