METASTATIC ORBITAL TUMORS

A review was made of the clinical data of 28 patients with metastatic orbital disease diagnosed in our clinic between 1972 and 1993. Fifteen were men and 13 were women, The average age at diagnosis was 58.7 yea rs. The right orbit was involved in 12 and the left orbit in 14 cases. Two cases had bilateral orbital involvement. Breast carcinoma was the most frequent tumor (8 of 28, 28.6%) followed by neuroblastoma (7 of 28, 25.0%), lung carcinoma (6 of 28, 21.4%), prostate carcinoma (3 of 28, 10.7%), gastrointestinal carcinoma (2 of 28, 7.1%), renal cell car cinoma and thyroid carcinoma (1 of 28, 3.6% each). Proptosis (67.9%), motility disturbance (57.1%) and mass (50.0%) were the three most comm on presenting signs. Enophthalmos was noted in two cases with breast c arcinoma. Nine cases presented with ophthalmic signs and metastatic tu mor was recognized later. In the remaining 19 cases, the diagnosis of the primary tumor preceded the onset of orbital metastasis, The time i nterval between the detection of the primary malignancy and metastatic orbital tumor was shortest for lung carcinoma (mean: 2 months) and lo ngest for breast carcinoma (mean: 34 months). Radiotherapy and chemoth erapy were applied in 12 cases. Improvement in orbital signs and visua l acuity was noted in 5 cases. Radiotherapy, chemotherapy and hormonal therapy were used in 8 patients and improvement in orbital signs was noted in 4 of these patients. Four of 28 patients (2 with breast carci nomas, one with prostate carcinoma and one with thyroid carcinoma) sur vived longer than 5 years. The mean survival time for patients with me tastatic orbital malignancy was 10.4 months.