Discrete metastasis of solid tumors to extraocular muscles
A. Capone Jr and T. L. Slamovits
Department of Ophthalmology, Eye and Ear Institute of Pittsburgh, Pa.
We report five cases of discrete solid tumor metastasis to extraocular
muscles. Computed tomography confirmed that orbital involvement in all
cases was confined to the extraocular muscles; there was no tumor in the
bony orbit or in the adjacent paranasal sinuses or intracranial space. In
two of our five cases, ophthalmic signs were the first evidence of
metastatic disease; in the three other cases, there was a known history of
cancer prior to orbital involvement. Pain, diplopia, and proptosis were the
most common presenting manifestations. Neuroimaging demonstrated bilateral
focal, nodular enlargement of multiple extraocular muscles in three cases.
Diffuse enlargement of a single muscle occurred in the two other cases,
inclusive of the tendinous insertion in one instance. Fine-needle
aspiration biopsy provided a diagnosis of undifferentiated malignancy in
all four cases in which it was performed.
