Orbital metastases from endocrine tumours

Orbital metastases (OM) are uncommon but clinically significant manifestations of systemic malignancy. Endocrine tumours represent a rare source of OM, often posing diagnostic and therapeutic challenges due to their variable presentation and indolent course. OM from endocrine tumours most commonly originate from differentiated thyroid carcinoma and neuroendocrine neoplasms. Presenting symptoms include proptosis, diplopia, pain and visual impairment, frequently mimicking inflammatory or primary orbital disorders. Imaging typically demonstrates mass-like orbital lesions, while in some cases definitive diagnosis based on histopathology may be required. Management is individualized and may include radiotherapy and/or surgical excision combined with systemic therapy in case of disseminated disease. Prognosis largely depends on the extent of systemic disease and tumour biology rather than orbital involvement alone. Although rare, OM should be considered in patients with endocrine malignancies presenting with orbital symptoms. Early recognition and multidisciplinary approach are essential to optimize visual outcomes, alleviate symptoms and guide systemic disease management.