Cervical carcinoma metastatic to the orbit

PURPOSE: To describe a case of orbital metastasis from an undifferentiated pelvic tumor with probable cervical origination. METHODS: Case report. Detailed ophthalmologic examination, orbital CT and MRI, and orbital biopsy with histologic and immunohistochemical analysis. RESULTS: A 29-year-old woman with a history of untreated cervical dysplasia was hospitalized with flank pain, hematuria, and abnormal vaginal bleeding. Biopsy of a large mass, protruding from the cervix as a grape-like cluster, had cellular morphology and immunohistochemical staining patterns consistent with cervical cancer. Diplopia in downgaze developed shortly after hospitalization. Ophthalmic examination was notable for mild right lower eyelid fullness, 1.5 mm right relative proptosis, and a deficit in supraduction and infraduction of the right eye. Orbital MRI and CT revealed a 1.2 x 1.6-cm mass immediately inferior and posterior to the right globe without bone involvement. On biopsy, the mass had histology similar to that of the pelvic tumor. On metastatic workup, lesions were found involving the left femoral head, liver, and spinal column, with adjacent lymphadenopathy. Despite treatment with radiation and chemotherapy, the patient died several months later of causes related to the systemic disease. CONCLUSIONS: Orbital metastasis of cancer originating in the cervix, despite its rarity, should be considered when an orbital mass of unknown cause is present.