1991 Volume 31 Issue 4 Pages 539-545
A 28-year-old male was admitted to Kagawa Medical School Hospital because of diplopia and left orbital mass. Orbital CT scan demonstrated an intraorbital mass and destruction of the orbit. Chest X-ray disclosed a nodular shadow in the right S6 and swollen lymph nodes in the right hilum and paratracheal area. Biopsy of the intrabronchial tumor yielded a diagnosis of small cell lung carcinoma (intermediate cell type). Systemic chemotherapy including ADM, CDDP and VP-16 was started on February 20, 1986. The masses in the orbit and right lung responded well to the chemotherapy. Therefore, the orbital mass was speculated to be a metastasis of small cell carcinoma. After 4 courses of induction therapy, he received maintenance chemotherapy as an outpatient for 18 months. He died 32 months after initial treatment because of systemic metastasis, but no orbital relapse was recognized.
Metastasis of lung carcinoma to the orbit has been considered to be uncommon in Japan. Only 6 cases have been reported in the literature; 3 were adenocarcinoma and the other 3 were squamous cell carcinoma. The present case is the first case in which small cell carcinoma of the lung had already spread to the orbit at the time of diagnosis. It should also be noted that systemic chemotherapy yielded a much longer remission period than expected.
