Journal List > J Korean Ophthalmol Soc > v.58(4) > 1010749

Jeon, Cho, and Choi: A Case of Small Cell Lung Cancer Diagnosed via Incisional Biopsy of an Orbital Mass

Abstract

Purpose

To report a case of an orbital mass diagnosed as metastasis from small cell lung cancer and to provide a review of the literature.

Case summary

A 66-year-old male with a history of diabetes mellitus and hypertension presented with decreased visual acuity and exophthalmos in his left eye. He had been diagnosed with age-related macular degeneration 13 years prior and had a his-tory of pneumonia that was treated for one month. The best corrected visual acuity was hand-motion in the right eye and 0.04 in the left eye. Optic disc swelling and splint hemorrhage of the left eye was observed on fundus examination. The left eye was pro-truded and eye movement was limited. On orbital magnetic resonance imaging, an irregular mass in the left intraconal space was found. Incisional biopsy was performed, and histopathologic examination revealed a small round tumor. According to the results of immunohistochemical staining, metastatic tumors were suspected. After systemic evaluation, the patient was diagnosed with primary small cell lung cancer with multiple metastases. After 2 months, the visual acuity was hand-motion and proptosis was not resolved.

Conclusions

In patients with orbital masses, the possibility of metastatic tumors should be considered during differential diag-nosis and early biopsy should be performed.

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Figure 1.
Magnetic resonance image of the patient (A: axial, B: coronal). Moderate to high intensity intraconal mass with irregular margin was observed in T2 image.
jkos-58-463f1.tif
Figure 2.
Metastatic poorly differentiated neuroendocrine carcinoma was considered on histopathologic findings. Small round cell was found in Hematoxylin and eosin staining (A: ×40, B: ×400). The tumor cells shows positivity for synaptophysin, one of the neuroendocrine marker (C: ×200).
jkos-58-463f2.tif
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