Abstract
Case summary
A 73-year-old male presented to our clinic with a palpable mass in his left upper eyelid that had appeared 10 days prior. The patient had a history of colon cancer that was diagnosed 2 years previously with liver and lung metastases, and he had underwent colon resection followed by chemotherapy. A 10.7 × 14.7 × 9.0 mm mass was observed on orbital computed tomography and a biopsy confirmed that the mass was a metastatic colonic adenocarcinoma. Because radical resection of the mass could not be performed, a debulking surgery was performed instead. The patient was followed up while receiving conservative treatment, but he died 3 weeks after surgery.
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Figure 1.
(A) A photograph taken at initial presentation shows a diffuse erythematous and edematous lesion. The mass was palpable in the left upper eyelid. (B) A photograph taken on the day of debulking surgery, 1 month after initial presentation, shows a rapidly growing mass and near total ptosis of the left upper eyelid.
![jkos-56-950f1.tif](/upload/SynapseXML/0035jkos/thumb/jkos-56-950f1.gif)
Figure 2.
(A) Coronal and (B) axial computed tomography images of the orbit showing an enhanced 10.7 × 14.7 × 9.0 mm mass in the left upper eyelid (white arrow). (C, D) One month later, orbital magnetic resonance imaging was performed; T2-weighted (C) axial and (D) coronal images show an approximately 28.0 × 11.0 × 10.0 mm well-defined enhancing mass (white arrow). The mass showed rapid growth and its size was increased compared to that observed 1 month previously.
![jkos-56-950f2.tif](/upload/SynapseXML/0035jkos/thumb/jkos-56-950f2.gif)
Figure 3.
(A) Immunohistochemistry for CK20 shows brown positive staining of the tumor section (×400) (black arrows). (B) Immunohistochemistry for CK7 is negative (×400). (C, D) Moderately differentiated metastatic colonic adenocarcinoma shows an irregular, glandular structure (C, hematoxylin and eosin staining, ×200, D, hematoxylin and eosin staining, ×400) (D: black arrows).
![jkos-56-950f3.tif](/upload/SynapseXML/0035jkos/thumb/jkos-56-950f3.gif)