Adrenocortical carcinoma metastatic to the orbit

Purpose: To describe the clinical course and histopathologic features of a patient with adrenocortical carcinoma metastatic to the orbit. Methods: Case report and literature review. Results: A 24-year-old man first came to medical attention because of sympt oms referable to a 4.47-kg, nonfunctioning carcinoma of the left adrenal co rtex. Several metastases ensued, including a large tumor to the right super ior lateral bony orbit with extension to the brain, temporalis fossa, and o rbit proper. The tumor was resected with the use of a combined neurosurgica l, ophthalmic, and craniofacial approach. The patient died of widespread me tastatic disease 15 months after the orbital operation. Conclusions: Metastasis to the orbit from adrenocortical carcinoma is rare. Surgical resection is the treatment of choice, with adjunctive radiation t herapy and chemotherapy in some cases. The prognosis is poor.