A Case of Primary Lung Cancer With Initial Symptoms Due to Orbital Metastases
Hanae Mori Naoko Maekawa Naoki Satoda Naoki Otsuka Naoki Sakai Tatsuo Fukuse
Department of Respiratory Medicine, Otsu Red Cross Hospital, Otsu, Japan
We encountered a case of lung cancer in which symptoms due to orbital metastasis were recognized. A 55-year-old man presented with a chief complaint of double vision. Orbital MR image demonstrated a right intraorbital mass with bone destruction, which resulted in oculomotor nerve palsy and optic nerve disturbance. Chest CT scan showed a 4 cm mass in the right S6, which was diagnosed on biopsy as a poorly differentiated adenocarcinoma. A whole-body scintigram revealed multiple bone metastases: the right orbital wall, the lower cervical spine, the left knee joint, and so on. Based on the clinical findings, we believed that the orbital tumor was a metastasis from the lung. Systemic chemotherapy and irradiation of the right orbital tumor and the left knee joint were performed. Though a favorable response was achieved in ocular movement, the patient died 3 months after initial treatment because of progression of the primary lesion. Including this case, seventeen reported cases in which lung cancer metastasized to the orbit in Japan were also reviewed.
Double vision Oculomotor nerve palsy Orbital metastases Orbital apex syndrome Primary lung cancer
Received 平成14年4月22日
JJRS, 41(1): 19-24, 2003