Bumpy muscles.
A 63-year-old man developed bilateral conjunctival injection and irritation followed by periocular discomfort and diplopia. Within weeks left proptosis and intermittent fever were noted. Orbital CT scan showed bilateral nodular enlargement of multiple extraocular muscles. Fine needle aspiration biopsy of the extraocular muscles revealed neoplastic cells compatible with a renal cell carcinoma. The bilateral extraocular muscle metastases were the initial manifestations of the underlying malignancy.
Slamovits
T L
TL
Department of Ophthalmology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
Burde
R M
RM
D001707:Biopsy, Needle; D002292:Carcinoma, Renal Cell / Q000473:pathology*; D003230:Conjunctival Neoplasms / Q000556:secondary; D004172:Diplopia / Q000209:etiology; D005134:Eye Neoplasms / Q000473:pathology / Q000556:secondary*; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000473:pathology*; D014057:Tomography, X-Ray Computed