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Year : 2022  |  Volume : 15  |  Issue : 1  |  Page : 85-88

Orbital metastases as the initial clinical manifestation of thyroid carcinoma: A case series

1 Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia – Cipto Mangunkusumo Kirana Eye Hospital, Jakarta, Indonesia
2 Department Internal Medicine, Faculty of Medicine, Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Correspondence Address:
Dr. Mutmainah Mahyuddin
Jl. Kimia No. 8, Jakarta 10320
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ojo.ojo_76_21

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Thyroid carcinoma rarely metastasizes to the orbit. Approximately only 2%–7% of orbital metastatic lesion were found originally from thyroid carcinoma. We present three cases to increase the awareness of orbital metastases as the initial manifestation of thyroid carcinoma. Three female patients aged 28–65 years old presented with initial complaint of orbital mass. Further examination discovered an asymptomatic lump on every patient's neck. However, one patient was unaware of her lump. Examination revealed that all lesions were metastases from papillary thyroid carcinoma. These cases conclude several similarities. First, prominent unilateral proptosis, orbital mass in the superior quadrant, limited eyeball movement, and orbital bone destruction were found in every patient. Second, all the orbital computed tomography scan showed extraconal solid masses involving adjacent structures and expanding intra-cranially or intrasinusly. These findings should raise one's suspicion of a metastatic lesion primarily caused by thyroid carcinoma. Despite the rarity of orbital metastases, thyroid carcinoma must be considered as a potential primary tumor in patients with initial presentation of orbital mass. Thorough physical examination is important to determine the origin of metastases.

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