Orbital metastasis may be the initial manifestation of a malignancy of unknown origin. The primary locations of orbital metastasis are usually the lung, prostate, gastrointestinal tract, skin, kidney, eye, or thyroid gland. Metastasis of gastric carcinoma to an extraocular eye muscle is extremely rare. A solitary thickening in an extraocular eye muscle with no inflammatory features is suspect for a tumor. Symptoms such as diplopia, proptosis, ptosis, vision loss, or pain may be associated with an orbital malignancy. Our patient, a 67-year-old man known with radically resected prostate cancer, presented with complaints of vertigo with a tendency to fall, headache, and diplopia when looking to the right. As a coincidental finding, swelling of the rectus lateralis muscle of the left eye was observed on imaging. Extensive additional investigations showed that a gastric carcinoma with intraorbital and leptomeningeal metastasis was the cause. In conclusion, a solitary thickened extraocular eye muscle should be recognized in time and examined further.
Case Rep Ophthalmol 2021;12:870–874

中文翻译：

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复视是胃癌的第一个征兆

眼眶转移可能是来源不明的恶性肿瘤的最初表现。眼眶转移的主要部位通常是肺、前列腺、胃肠道、皮肤、肾脏、眼睛或甲状腺。胃癌转移至眼外眼肌极为罕见。没有炎症特征的眼外眼肌中的孤立性增厚被怀疑为肿瘤。复视、眼球突出、上睑下垂、视力丧失或疼痛等症状可能与眼眶恶性肿瘤有关。我们的患者是一位 67 岁的男性，患有前列腺癌根治术，主诉眩晕、跌倒倾向、头痛和向右看时复视。作为一个巧合的发现，在成像中观察到左眼外直肌肿胀。广泛的额外调查表明，具有眶内和软脑膜转移的胃癌是原因。总之，应及时发现孤立性增厚的眼外眼肌并进一步检查。
Case Rep Ophthalmol 2021；12:870–874