Esophageal Adenocarcinoma and Urothelial Carcinoma Orbital Metastases Masquerading as Infection.

[esophageal adenocarcinoma]

Abstract Orbital metastases can masquerade as other orbital processes . We present two cases of orbital metastases , the first being the first reported adenocarcinoma of the esophagus presenting as an orbital metastasis prior to the primary being known , and the other as the first urothelial carcinoma to present as orbital cellulitis . The first patient presented with left upper eyelid pain . CT scan identified a superolateral subperiosteal fluid collection without concomitant sinus disease , which was drained in the operating room . Two weeks later repeat CT scan showed recurrent orbital subperiosteal fluid . It was drained and a biopsy showed necrotic adenocarcinoma . The second case presented with a painless right proptosis , decreased vision , and globally decreased ocular motility 3 days after bladder resection for urothelial carcinoma . CT scan demonstrated pan sinusitis with a soft tissue mass in the apex of the right orbit with extension through the superior orbital fissure . After no improvement on antibiotics endoscopic drainage was performed . Pathology revealed metastatic urothelial carcinoma within the orbital fat .