Henry Ford Hospital Medical Journal


Orbital metastasis is associated with enophthalmos in up to one third of all cases. After analyzing the clinical and pathologic features In 25 reported cases of enophthalmic orbital metastasis, the condition was found to almost exclusively affect females, usually in the 60 to 70 age group. The right orbit was the most commonly affected. The primary lesion was located in the breast in 19 (76%) cases and in the abdomen in 6 (24%) cases. In one third of the cases, the manifestations of the orbital metastasis were recognized before diagnosing the primary lesion. The most common presenting features were diplopia with ophthalmoplegia, ptosis, and decreased vision. Enophthalmos was usually less than 6 mm. The clinical findings of enophthalmos, ophthalmoplegia, blepharoptosis, and a resistance to ocular retropulsion strongly suggests the presence of an orbital metastasis, even in patients without a previous history of cancer. Following a thorough systemic evaluation, an open orbital biopsy should be performed, if possible, to confirm the pathologic diagnosis. Special histologic techniques and laboratory studies may be valuable in directing further palliative therapy.