• Ann Acad Med Singap · Oct 2006

    Case Reports

    Orbital metastatic tumour as initial manifestation of asymptomatic gastric adenocarcinoma.

    • Kelvin Y C Lee, Aliza Jap, Elizabeth Cheah, and Audrey Looi.
    • Singapore National Eye Centre. Singapore.
    • Ann Acad Med Singap. 2006 Oct 1; 35 (10): 719-22.

    IntroductionMetastatic 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.Clinical PictureWe 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.Treatment And ResultsExcisional 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.ConclusionEarly 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.

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