Metastatic small cell carcinoma masquerading as orbital myositis
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Abstract:
A case of discrete metastases to an extraocular muscle from a silent small cell carcinoma is described. Clinically, diagnostically, and pathologically this masqueraded as orbital myositis. It was not until a full thickness muscle biopsy was obtained that the diagnosis was realized. The need for deep biopsy is stressed. Discrete metastases to an extraocular muscle without other orbital soft tissue involvement is rarely reported. This is the first reported case from a small cell primary tumor. Metastatic orbital disease is discussed.
Insights
A rare case of small cell carcinoma metastasizing to an extraocular muscle mimicked orbital myositis. A deep muscle biopsy was crucial for diagnosis, highlighting the importance of thorough investigation for metastatic orbital disease.
Area of Science:
- Ophthalmology
- Oncology
- Pathology
Background:
- Metastatic orbital disease is uncommon, with metastases typically involving orbital soft tissues.
- Small cell carcinoma is an aggressive cancer that can metastasize distantly.
Observation:
- A patient presented with symptoms mimicking orbital myositis.
- Clinical, diagnostic, and pathological findings initially suggested an inflammatory condition.
Findings:
- A discrete metastasis to an extraocular muscle from a silent small cell carcinoma was identified.
- Diagnosis was only confirmed after a full-thickness muscle biopsy, revealing cancer cells and not inflammation.
Implications:
- This case underscores the importance of considering metastatic disease in orbital presentations that mimic myositis.
- Deep, full-thickness biopsies are essential for accurate diagnosis in such rare presentations.
- This is the first reported instance of extraocular muscle metastasis from a primary small cell carcinoma without other orbital soft tissue involvement.