Orbital Metastasis by Nasopharyngeal Carcinoma with Exophthalmos after Traumatic Orbital Fracture - A Case Report

1. Peishin Hu^1,2
2. Jiunn-Feng Hwang¹
3. Chien-Chi Tseng¹
4. San-Ni Chen¹

¹Department of Ophthalmology, Changhua Christian Hospital, Changhua, Taiwan
²Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

Purpose: To report a masquerade case of orbital metastasis by nasopharyngeal carcinoma with exophthalmos after traumatic orbital fracture.

Methods: Case report.

Results: A 38-year-old male suffered from diplopia with upper gaze limitation in his left eye. The patient had a history of ocular blunt injury. His left eye had unresolved upper orbital swelling and progressive exophthalmos. Orbit CT showed medial orbital wall fracture and a superior extraconal mass, measured up to 2.63cm. Pathological study disclosed lymphoepithelioma-like carcinoma with EBER-1 positive. Nasopharynx biopsy proved undifferentiated nasopharyngeal carcinoma. Tumor staging was T4N0M0.

Conclusions: Exophthalmos result from orbital metastasis of nasopharyngeal carcinoma is uncommon. The clinician should be alert about the possibility of orbital symptoms as the initial manifestation of nasopharyngeal carcinoma.