Hepatoma metastatic to the orbit

Area of Science:

• Hepatobiliary Neoplasms
• Ophthalmic Oncology
• Oncologic Imaging

Background:

• Hepatocellular carcinoma (HCC) is a primary liver malignancy with a known propensity for distant metastasis.
• Common sites of HCC metastasis include the brain, lungs, and bone.
• Orbital metastasis from HCC is exceptionally rare, with limited documented cases.

Observation:

• A 69-year-old male with a history of liver cirrhosis presented with unilateral proptosis.
• The patient exhibited no signs of jaundice, abdominal pain, or gastrointestinal distress.
• Initial laboratory and radiographic evaluations were unremarkable for metastatic disease.

Findings:

• Orbital biopsy confirmed the presence of hepatocellular carcinoma.
• This represents the first histologically documented instance of hepatoma metastatic to the orbit.
• The absence of typical metastatic symptoms underscores the atypical presentation.

Implications:

• This case expands the known metastatic spectrum of hepatocellular carcinoma.
• Ophthalmologists and oncologists should consider orbital metastasis in patients with HCC and proptosis, even without other systemic signs.
• Further research may elucidate the mechanisms and frequency of this rare metastatic pathway.