title: Metastatic orbital tumors in southern China during an 18-year period.
abstract: OBJECTIVE
  To determine the primary sites, clinical features, treatment, and outcome of 46 patients with cancer metastatic to the orbits in southern China.
  
  
  METHODS
  Retrospective review of medical records at a tertiary center in southern China between Jan 1, 1991 and Dec 31, 2008.
  
  
  RESULTS
  The study included 35 males and 11 females, with an age range of 3-78 years (average 47 years). All of the patients came from southern China. The left orbit was affected more frequently than the right orbit (3:2), and no cases were bilaterally involved. The most common primary cancer that metastasizes to the orbit is nasopharyngeal carcinoma (30.34%), followed by lung cancer (8.70%), liver cancer (6.52%), breast carcinoma (4.35%), renal cell cancer (4.35%), medullary thyroid carcinoma (2.17%), lacrimal gland carcinoma (2.17%), stomach carcinoma (2.17%), mediastinum carcinoma (2.17%), other forms (6.52%), and unknown carcinomas (30.34%). Orbital metastasis was the first sign of systemic cancer in 24 patients (52.17%). The five most common clinical findings at the initial examination were abnormal eye position (65.22%), proptosis (63.04%), increased orbital pressure (54.35%), diplopia (54.35%), and limited ocular motility (52.17%), followed by swollen eyelid (50%), visible mass or swelling (46%), blurred vision (41%), conjunctival hyperemia, and edema (35%), pain (28%), blepharoptosis (20%), papilledema (17%), and vasodilatation of the retina (7%). Primary treatment included surgical excision, radiotherapy, systemic chemotherapy, and observation. Among the patients (78% of 46) with sufficient follow-up time (mean 20.7 months), 30.56% of them died of disseminated metastasis. Twenty-five percent of them were in remission with no active metastases and 27.78% of them were living with active metastases. Overall, the mean survival time was 18 months (range, 5-38 months) after diagnosis of orbital metastasis.
  
  
  CONCLUSIONS
  The most common primary cancer that metastasizes to the orbit is nasopharyngeal carcinoma (30.34%), followed by lung cancer (8.70%) and liver cancer (6.52%) in southern China. Orbital metastasis can display a variety of clinical features and should be considered in patients with known systemic cancer. The systemic prognosis is generally poor.
authors.affiliation: The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 Xieli Nan Road, Guangzhou 510060, The People's Republic of China. Yan2011@tom.com
authors.forename: Jianhua
authors.initials: J
authors.lastname: Yan
authors.forename: Shaohui
authors.initials: S
authors.lastname: Gao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology; D002277:Carcinoma / Q000401:mortality* / Q000556:secondary* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000401:mortality / Q000473:pathology; D005843:Geography; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000401:mortality* / Q000473:pathology*; D009918:Orbital Neoplasms / Q000401:mortality* / Q000556:secondary* / Q000601:surgery; D011379:Prognosis; D013964:Thyroid Neoplasms / Q000401:mortality / Q000473:pathology; D055815:Young Adult