Orbital metastasis as the initial presentation of lung adenocarcinoma: a case report

Abstract

Liangchao Sun,1,2,* Yali Qi,1,3,* Xindong Sun,2 Jinming Yu,2 Xue Meng2 1Medical College of Shandong University, 2Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Science, Jinan, 3Department of Oncology, The Second Hospital of Lanzhou University, Lanzhou, People’s Republic of China *These authors contributed equally to this work Abstract: Orbital metastasis as the initial presentation of lung adenocarcinoma is very rare, and so the lack of knowledge about this phenomenon can easily result in misdiagnosis, either as a orbital primary tumor or benign lesion. Here, we report a rare case in which the orbital symptom appeared first without any pulmonary manifestations. Our patient developed decreasing vision in his right eye over a 3-month duration. He then presented with proptosis and multiple aches from head to back. After systemic evaluation, our patient was diagnosed with Stage IV non-small-cell lung cancer and was managed with palliative chemoradiotherapy. The final result of treatment suggests that the therapeutic efficacy of chemotherapy on orbital metastasis is uncertain, and only some orbital metastatic masses may have a favorable response to radiation. Furthermore, we review the recent data and provide an in-depth discussion on the clinical features and course of ocular pulmonary metastases, and explain a new type of non-small-cell lung cancer metastatic pattern for ophthalmologists and oncologists to help them distinguish the orbital metastasis as the first manifestation. Keywords: orbital metastasis, skeletal metastasis, rare metastasis, initial presentation, lung adenocarcinoma

Keywords

• orbital metastasis
• skeletal metastasis
• rare metastasis
• initial presentation
• lung adenocarcinoma