Intraconal extra-ocular malignant melanoma metastasis

Case contributed by Dr Jan Frank Gerstenmaier

Presentation

This patient with known metastases to the lungs from malignant (cutaneous) melanoma presented with a short history of left-sided proptosis, chemosis and ecchymosis. Orbital apex syndrome was suspected.

Patient Data

Age: 65
Gender: Male
CT

Contrast-enhanced CT orbits

On the left, there is a 2.5cm x 2.5cm x 2.5cm intraconal mass situated bewteen the optic nerve and lateral rectus. The mass is separate to, but displaces the optic nerve. There is no fat plane between the mass and the lateral rectus, but the belly of lateral recuts is of normal calibre. There is mild proptosis. The lateral orbital wall is normal. The orbital apex is not affected.

Case Discussion

Metastatic melanoma to the eyes and orbits is rare 1.  Breast cancer is the most common primary cancer to cause metastases to the orbits 2. Breast cancer metastases are often irregular lesions 3, in contradistinction to the mass seen in this case.

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Case information

rID: 22249
Case created: 22nd Mar 2013
Last edited: 22nd Mar 2016
Inclusion in quiz mode: Included

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