title: Asymptomatic pancreatic adenocarcinoma presenting as an orbital metastatic tumor.
abstract: Although rare, orbital metastatic tumors may be the initial presentation of an asymptomatic primary carcinoma. We report a rare case, with clinicopathological correlation, of metastatic pancreatic adenocarcinoma, presenting first in the orbit with symptoms of diplopia, blurring of vision and supraorbital ache. Computed tomography and magnetic resonance imaging of the orbit showed a left solid intraconal tumor with peripheral rim enhancement. The tumor demonstrated hypointensity on both T1- and T2-weighted sequences. Excisional biopsy was performed and histopathology confirmed a metastatic adenocarcinoma. Subsequent gastrointestinal imaging and tumor markers revealed an asymptomatic pancreatic adenocarcinoma, with multiple liver metastases. Our patient developed hepatobiliary sepsis and passed away 44 days after diagnosis. This case highlights the role of early biopsy of atypical orbital tumors in the localization of an asymptomatic primary carcinoma.
authors: Singapore National Eye Centre, Singapore.
authors: F Y
authors: FY
authors: Foo
authors: M
authors: M
authors: Lee
authors: A
authors: A
authors: Looi
mesh_terms: D000230:Adenocarcinoma / Q000737:chemistry / Q000000981:diagnostic imaging / Q000556:secondary*; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D004172:Diplopia / Q000175:diagnosis; D017809:Fatal Outcome; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009918:Orbital Neoplasms / Q000737:chemistry / Q000000981:diagnostic imaging / Q000556:secondary*; D010190:Pancreatic Neoplasms / Q000737:chemistry / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D014786:Vision Disorders / Q000175:diagnosis
chemical_list: D014408:Biomarkers, Tumor