A Case of Small Cell Lung Cancer Diagnosed via Incisional Biopsy of an Orbital Mass

Hyeshin Jeon; Myung Ho Cho; Hee Young Choi

doi:10.3341/jkos.2017.58.4.463

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

Original Article

J Korean Ophthalmol Soc 2017;58(4):463-466.

Published online: 8 September 2017

DOI: https://doi.org/10.3341/jkos.2017.58.4.463

A Case of Small Cell Lung Cancer Diagnosed via Incisional Biopsy of an Orbital Mass

Hyeshin Jeon, M.D.^1,², Myung Ho Cho, M.D.¹, Hee Young Choi, MD, PhD^1,^2,

^¹Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea

^²Medical Research Institute, Pusan National University Hospital, Busan, Korea

Address reprint requests to Hee Young Choi, MD, PhD Department of Ophthalmology, Pusan National University Hospital, #179 Gudeok-ro, Seo-gu, Busan 49241, Korea Tel: 82-51-240-7324, Fax: 82-51-242-7341 E-mail: hychoi@pusan.ac.kr

This work was supported by a 2-year Research Grant of Pusan National University.

Received 29 December 20169 February 2017 Accepted 22 March 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Exophthalmos, Orbital mass, Orbital metastasis

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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.

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).

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