Journal List > J Korean Ophthalmol Soc > v.53(12) > 1009271

Choi, Park, Seo, and Shin: A Case of Diagnosed Renal Cell Carcinoma with Orbital Metastasis Presenting with Proptosis

Abstract

Purpose

To report a very rare case of lacrimal gland metastasis of renal cell carcinoma presenting with proptosis.

Case Summary

A 68-year-old man visited our clinic with a 3-month history of proptosis in the right eye. Corrected visual acuity was 0.8 in the right eye and 0.9 in the left eye and 11 mm proptosis of the right eye was observed. There were no specific findings except cataracts in both eyes. Orbital computed tomography (CT) demonstrated a solid lacrimal gland mass which was 24 × 36 × 29 mm in size and showed irregular enhancement. The CT scan also showed bone destruction around the orbital lateral wall and infiltration to the lateral rectus muscle. A metastatic tumor was suspected, thus a chest CT and abdominal CT were performed. The CT scan showed a large exophytic hypervascular mass with heterogeneous enhancement. The mass size was confirmed by the abdominal CT and malignant tumors were suspected. Regarding the left renal mass, a urology surgeon performed nephrectomy and adrenalectomy and regarding the lacrimal gland mass we performed an incisional biopsy via lid crease incision. Both masses were diagnosed as renal cell carcinoma based on the pathophysiologic findings.

Conclusions

Lacrimal gland metastasis of renal cell carcinoma is very rare and extensive systemic evaluation for metastatic malignancy should be performed. In the present study, the authors report of a primary tumor found by chest CT a review of the literature.

Figures and Tables

Figure 1
Clinical photographs showing large exophthalmos of the right eye.
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Figure 2
Coronal and axial CT scans showing irregular, solid mass in the right lacrimal gland, around bony destruction and infiltration to lateral rectus muscle. Axial (A) and coronal (B) views.
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Figure 3
Abdominal CT scans showing exophytic, lobulating contoured, hypervascular and irregular enhanced mass.
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Figure 4
Renal cell carcinoma. Microscopically two tumors exhibited large polygonal clear epithelial cells with abundant foamy cytoplasm (arrow). Renal (A) and orbital (B) mass (hematoxilin-eosin, ×100).
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