A case of misconstrue proptosis

This case illustrates an overlooked metastatic lung carcinoma to the orbit. The rapid onset of symptoms and oedema mimicked a cellulitis. The patient was initially treated with a broad-spectrum topical and intravenous antibiotic therapy. The white blood cell count (WBC) and C reactive protein (CRP)...

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Bibliographic Details
Published in:BMJ case reports Vol. 2013; p. bcr2012008410
Main Authors: Chiam, Patrick J T, Ho, Vivian W-M, Hubbard, Alan D, Weerasinghe, Suboda
Format: Journal Article
Language:English
Published: England BMJ Publishing Group Ltd 23.04.2013
BMJ Publishing Group LTD
BMJ Publishing Group
Series:Case Report
Subjects:
71-80 years
Abdomen
Aged
Biopsy
Bronchoscopy
Cancer
Cellulitis
Chemotherapy
Diagnosis, Differential
Exophthalmos - diagnosis
Exophthalmos - etiology
Exophthalmos - therapy
Family medical history
Humans
Hyponatremia
Learning from Errors
Lesions
Lung cancer
Lung Neoplasms - diagnostic imaging
Lung Neoplasms - pathology
Male
Medical diagnosis
Medical imaging
Medical prognosis
Metastasis
Orbital Neoplasms - diagnosis
Orbital Neoplasms - secondary
Orbital Neoplasms - therapy
Patients
Radiation therapy
Retinal detachment
Thyroid gland
Tomography, X-Ray Computed
Tumors
United Kingdom
White
ISSN:1757-790X, 1757-790X
Online Access:Get full text
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Description
Summary:This case illustrates an overlooked metastatic lung carcinoma to the orbit. The rapid onset of symptoms and oedema mimicked a cellulitis. The patient was initially treated with a broad-spectrum topical and intravenous antibiotic therapy. The white blood cell count (WBC) and C reactive protein (CRP) were normal. Compressive optic neuropathy and serous retinal detachment ensued. The initial chest x-ray revealed lung shadows; however, this was not reviewed. Eventually, CT of the chest was organised and showed a lung mass. The management of such a case remains a challenge for the uninitiated, and high index of suspicion is required to ensure early appropriate management. Despite complete resolution of the swelling with sequential chemotherapy (cisplatin and etoposide) and radiotherapy, the visual prognosis remained grim.
Bibliography:CASE REPORT
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ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2012-008410