Abstract
Orbital metastasis, as the initial clinical presentation in hepatocellular carcinoma
(HCC), is a rare manifestation. A 66-year-old male patient presented with a history
of protrusion of the eyeballs, double vision, and swelling over the left side of the
head for 8 months. Magnetic resonance imaging of the brain with orbit revealed a heterogeneous
lesion in the left frontal lobe causing its destruction with intraorbital and intracranial
extension. Triphasic contrast-enhanced computed tomography was suggestive of multiple
hypodense areas in both lobes of the liver. Tissue diagnosis from the liver was suggestive
of HCC. A diagnosis of multifocal HCC with orbital metastasis was made. The patient
was treated with palliative radiotherapy and sorafenib. Orbital metastasis in HCC
is rare. Prognosis is somber in such cases. The treatment should focus on providing
palliation from symptoms.
Keywords
hepatocellular carcinoma - metastasis - orbital - palliation - radiotherapy
