Acute inflammatory presentation of orbital metastasis from urothelial carcinoma: a case report

ABSTRACT

Orbital metastasis of urothelial carcinoma is very rare; only 22 cases have been documented. In this case report, we describe a patient 1 month status post transurethral resection of urothelial carcinoma who presented with a clinical picture suggestive of orbital cellulitis. However, neither broad-spectrum antibiotics nor a subsequent trial of methylprednisolone was effective at relieving the patient’s symptoms. CT imaging of the head, chest, abdomen, pelvis, and lower extremity showed no signs of metastatic disease. Six days after presentation, punch biopsy of the mass was performed and confirmed urothelial carcinoma metastatic to the orbit. The patient died 3 months later due to multiple sites of distant metastasis. This case report suggests that a high index of suspicion for orbital metastasis is important for patients with a history of urothelial carcinoma with new and acute onset of ocular symptoms and emphasizes the need for urgent systemic evaluation and treatment.

KEYWORDS:

• Orbital metastasis
• transitional cell cancer
• urothelial cancer

Availability of data

Available on request.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Ethics approval

This case report was approved as an exempt study by the University of Texas Health Science Center San Antonio Institutional Review Board.

Informed consent

As the patient was deceased at the time of the preparation of this case report, written informed consent for this case report as well as its publication was obtained from the patient’s next of kin.

Additional information

Funding

The authors did not receive support from any organization for the submitted work.