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

Purpose: 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).

Methods: A case report and literature review study.

Result: 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.

Conclusion: 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.