To evaluate the clinical characteristics of metastatic orbital tumors.

The medical records of patients who were diagnosed with metastatic orbital tumors at Asan Medical Center, Seoul, Republic of Korea, from May 2010 to May 2017, were retrospectively reviewed.

A total of 27 patients were studied, including 14 (51.9%) males. The mean age at diagnosis was 54.1 years and the mean follow-up period was 12.7 months. The most common primary tumor site was the breast (six patients, 46.2%) in females and the liver (five patients, 35.7%) in males. Proptosis (12 patients, 44.4%) was the most common complaint, with the other complaints including periorbital swelling, palpable masses and diplopia. Orbital imaging studies showed that the most common sites of orbital involvement were the orbital wall (nine patients, 33.3%) and the extraocular muscle (nine patients, 33.3%). Pathological diagnoses were performed in 10 patients (37.0%), 3 of these whom underwent a fine needle aspiration biopsy for intraconal lesions. Local and systemic therapies were conducted using a multidisciplinary approach, but the size of orbital tumors increased in 12 (44.4%) of 27 patients. Eight (29.6%) patients died because of systemic metastasis, seven (25.9%) patients were referred to other institutions for palliative treatment, and five (18.5%) patients showed malignant progression despite treatment.

Based on the varying clinical features of metastatic orbital tumors, it is important to carefully diagnose patients, especially those with a history of cancer. Breast cancer is the most common primary cancer, and liver cancer is also common because of the high prevalence of hepatocellular carcinoma in the Republic of Korea. Clinical diagnosis may be possible using patient history and/or imaging study data, but pathological confirmation may be necessary in some cases. The treatment options can be determined by the type of primary cancer and the general condition, but the overall prognosis is poor.