Fulminant Course of Isolated Orbital Metastasis From Gastric Cancer: A Case Report

Orbital metastases are uncommon, with breast cancer being the most frequent primary tumor. In contrast, metastasis from gastric cancer to the orbit is exceedingly rare and often indicates advanced disease with a poor prognosis. We report the case of a 43-year-old woman previously treated for localized signet-ring cell gastric adenocarcinoma with chemotherapy followed by total gastrectomy. One month after surgery, she developed acute right-sided proptosis, diplopia, and retro-orbital pain. Magnetic resonance imaging (MRI) revealed a right orbital mass encasing the globe, optic nerve, and extraocular muscles, consistent with a solitary orbital metastasis. Her clinical condition deteriorated rapidly, and she died within days of diagnosis. Histological confirmation could not be obtained due to her rapid decline. Although rare, orbital metastasis may be the first and only manifestation of gastric cancer recurrence. Clinicians should maintain a high index of suspicion in any cancer patient presenting with new-onset ocular symptoms, as early diagnosis is critical for symptom management and prognostic assessment.