J Korean Ophthalmol Soc > Volume 57(8); 2016 > Article
Journal of the Korean Ophthalmological Society 2016;57(8):1320-1324.
DOI: https://doi.org/10.3341/jkos.2016.57.8.1320    Published online August 15, 2016.
Two Cases of Extraocular Muscle Enlargement Caused by Metastatic Cancer.
Jae Woo Jung, Jae Ho Jung
Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea. jungjaeho@pusan.ac.kr
악성종양 전이로 발생한 외안근 비대 2예
정재우⋅정재호
부산대학교 의학전문대학원 양산부산대학교병원 안과학교실
Correspondence:  Jae Ho Jung,
Email: jungjaeho@pusan.ac.kr
Received: 7 April 2016   • Revised: 4 May 2016   • Accepted: 1 July 2016
Abstract
PURPOSE
To report two cases of extraocular muscle enlargement due to malignant cancer metastasis. CASE SUMMARY: A 56-year-old woman presented with horizontal diplopia first noted 1 month earlier. She had a history of small cell lung cancer with brain and bone metastases. She had a -3 abduction deficit in the right eye and esotropia. The forced duction test showed no limitation in horizontal movement. Antibody tests for thyroid disease showed normal results. Brain magnetic resonance image showed multiple nodular enlargements of the right lateral and medial rectus muscles, al so multiple metastatic nodules in the brain. A 38-year-old woman presented with horizontal diplopia first noted 3 months previously. She had undergone breast cancer surgery 6 months earlier. The patient had a -4 abduction deficit in the left eye and esotropia. The forced duction test showed no limitation in horizontal movement. Antibody tests for thyroid disease showed normal results. Orbital magnetic resonance imaging showed nodular enlargement of left lateral rectus muscle including a tendon. CONCLUSIONS: Extraocular muscle metastasis is a possible cause of extraocular enlargement and paralytic strabismus. In a patient with malignant cancer, the physician should consider the possibility of extraocular muscle metastasis and perform imaging for early diagnosis and treatment.
Key Words: Diplopia;Extraocular muscle enlargement;Extraocular muscle metastasis;Paralytic strabismus


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