Orbital metastatic tumour as initial manifestation of asymptomatic gastric adenocarcinoma.
BACKGROUND
Metastatic orbital tumour from gastric cancer is rare. Patients with metastatic disease may present initially to the ophthalmologist with symptoms from metastases instead of from the primary cancer.


METHODS
We report a case, with clinicopathological correlation, of metastatic gastric adenocarcinoma presenting first in the orbit with diplopia. Computed tomography and magnetic resonance imaging of the orbit showed a well-defined enhancing right intraconal tumour.


RESULTS
Excisional biopsy was performed and histopathology confirmed a metastatic adenocarcinoma. Focused gastrointestinal screening revealed an otherwise asymptomatic Stage IV gastric adenocarcinoma. Chemotherapy was initiated with good tumour response.


CONCLUSIONS
Early biopsy of unusual orbital tumours is critical as orbital metastases may be the initial manifestation of an asymptomatic primary. Histopathological diagnosis can aid localisation of the primary tumour and allow prompt treatment to be instituted.
Lee
Kelvin Y C
KY
Singapore National Eye Centre. Singapore.
Jap
Aliza
A
Cheah
Elizabeth
E
Looi
Audrey
A
D001706:Biopsy; D004172:Diplopia / Q000473:pathology*; D006392:Hemangioma, Cavernous / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009918:Orbital Neoplasms / Q000556:secondary / Q000601:surgery*; D013274:Stomach Neoplasms / Q000473:pathology*; D013997:Time Factors