Metastases to the eye or orbit as the initial presentation of genitourinary malignancy are unusual and can be a diagnostic challenge.
We report an 81-year-old man who presented with pain and proptosis in an eye that had been blind for 50 years. Radiologic investigations identified a mass involving the left globe and orbit. Histology of the enucleation specimen was consistent with a metastatic poorly differentiated carcinoma suggestive of a prostate primary. With the constellation of obstructive urinary symptoms, an abnormal digital rectal examination, elevated prostate-specific antigen and a positive bone scan, androgen deprivation therapy was initiated for metastatic prostate cancer. After an initial response to treatment, the patient's disease progressed in a manner atypical for prostate cancer. After describing our case, we review the literature on ocular and orbital metastases and their relation to genitourinary malignancies.
Written by:
Lefresne S, Fairchild A, Johnson R, Deschenes J, Russell L, Pederson J. Are you the author?
Department of Radiation Oncology, BC Cancer Agency, Vancouver, BC.
Reference: Can Urol Assoc J. 2012 Apr;6(2):E67-71.
doi: 10.5489/cuaj.10174
PubMed Abstract
PMID: 22511437