Fact-sheet: Metastasis to orbit
Updated on 10/07/2017 at 8:43 AM
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Definition
Secondary intraorbital extraocular lesion in the majority of cases. Rare pathology ( Most common primary tumors: - Breast - Lung - Prostate - Thyroid - Kidney
Clinical features
Diplopia
Decreased visual acuity
Ocular pain
Exophthalmos
CT
- Well-defined lesion or poorly defined infiltration of the orbital fat
- Most often extraconal
- Spontaneous density greater than fat, isodense to the oculomotor muscles
- Enhancement after iodinated contrast administration
- +/- bone invasion
MRI
Classically isointense on T1 and hyperintense on T2 relative to muscle, with enhancement after gadolinium injection.
Fat Sat sequences are particularly useful
Management
- Treatment of the primary tumor
- Orbital radiotherapy
- Surgery in rare cases (solitary lesion)
Differential diagnosis
X Malignant orbital tumor:
- Lymphoma
- Lacrimal gland tumor
- Rhabdomyosarcoma
x Vascular tumors (hemangiomas...)
x Optic nerve tumor:
- Glioma
- Meningioma
x Infection
x Inflammatory or granulomatous pathology
- Sarcoidosis
- Pseudotumor of orbit
x Graves orbitopathy