title: Esophageal adenocarcinoma and urothelial carcinoma orbital metastases masquerading as infection.
abstract: Orbital metastases can masquerade as other orbital processes. We present two cases of orbital metastases, the first being the first reported adenocarcinoma of the esophagus presenting as an orbital metastasis prior to the primary being known, and the other as the first urothelial carcinoma to present as orbital cellulitis. The first patient presented with left upper eyelid pain. CT scan identified a superolateral subperiosteal fluid collection without concomitant sinus disease, which was drained in the operating room. Two weeks later repeat CT scan showed recurrent orbital subperiosteal fluid. It was drained and a biopsy showed necrotic adenocarcinoma. The second case presented with a painless right proptosis, decreased vision, and globally decreased ocular motility 3 days after bladder resection for urothelial carcinoma. CT scan demonstrated pan sinusitis with a soft tissue mass in the apex of the right orbit with extension through the superior orbital fissure. After no improvement on antibiotics endoscopic drainage was performed. Pathology revealed metastatic urothelial carcinoma within the orbital fat.
authors.affiliation: Storm Eye Institute , Charleston, South Carolina , USA and.
authors.forename: George N
authors.initials: GN
authors.lastname: Magrath
authors.forename: Charles M
authors.initials: CM
authors.lastname: Proctor
authors.forename: Wade A
authors.initials: WA
authors.lastname: Reardon
authors.forename: Krishna G
authors.initials: KG
authors.lastname: Patel
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Lentsch
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Eiseman
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary*; D001706:Biopsy; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D004938:Esophageal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009918:Orbital Neoplasms / Q000556:secondary*; D010166:Palliative Care; D001749:Urinary Bladder Neoplasms / Q000473:pathology*
keywords: Adenocarcinoma; cellulitis; metastasis; oncology