DR. PARAG TYAGI

DR.SAHIL AGRAWAL, DR. RACHNA MEEL, DR. SEEMA KASHYAP

Abstract

Due to the increased longevity of cancer patients and advances in diagnostic modalities, a new subset of patients with orbital metastasis is being observed with increasing prevalence. Here, we report a lady in her 40’s who presented with complaints of painless protrusion of the left eyeball with restricted motility and reduced vision. Based on characteristic ultrasonography findings corroborated by a benign appearance of the lesion on CT and MRI, a diagnosis of cavernous hemangioma was made and the patient underwent excision biopsy. However intraoperatively, it was found to be a densely pigmented lesion which on histopathological examination turned out to be a malignant melanoma. Subsequently, extensive systemic evaluation revealed the primary tumour to be a melanoma of anorectal origin with widespread metastasis. Thus, the ophthalmic surgeon should keep metastasis with the differential whilst working up cases of orbital mass, especially in the elderly.