A case report and literature review of rare isolated metastatic papillary thyroid carcinoma in the orbit

Orbital metastasis secondary to thyroid carcinoma is an exceedingly rare occurrence. In this case report, we present a rare isolated orbital metastasis of papillary thyroid carcinoma (PTC).

A case report and literature review study.

A 55-year-old female, who presented with right-sided exophthalmos persisting for seven months and a week-long history of decreased visual acuity. Orbital computed tomography (CT) revealed a solid, isolated, well-circumscribed mass confined to the right intra-conal orbital cavity. Surgical excision via lateral orbitotomy confirmed the diagnosis of metastatic PTC.

Most cases reported in the literature have identified orbital masses concurrently with the initial diagnosis of thyroid carcinoma. In contrast, our patient exhibited ocular symptoms following a prolonged interval after normal post ablative iodine imaging, highlighting a significant delay in metastatic presentation. Moreover, the solid and well-defined nature of the metastatic orbital mass, confined solely to the orbital cavity without evidence of bony destruction, muscle involvement or intracranial extension in this patient, constitutes a distinctive clinical feature rarely documented in existing case reports.