Unilateral Exophthalmia Revealing an Orbital Metastasis from Esophageal Adenocarcinoma: A Case Report and Review of the Literature

Abstract

Orbital metastases are uncommon manifestations of systemic malignancies and are most frequently associated with breast, lung, and prostate cancers. Digestive tract tumors rarely metastasize to the orbit, and esophageal adenocarcinoma represents an exceptional cause. We report the case of a 56-year-old man in whom esophageal adenocarcinoma was revealed by unilateral exophthalmia secondary to an osteolytic orbital metastasis. The patient presented with progressive dysphagia and significant weight loss. Imaging revealed an orbital mass with fronto-temporal extension, and histopathological analysis confirmed metastatic disease of esophageal origin. Upper gastrointestinal endoscopy demonstrated a budding tumor of the lower esophagus, histologically consistent with moderately differentiated adenocarcinoma. Given the presence of liver metastases and altered general condition, the patient was managed with palliative intent. This case highlights the importance of considering esophageal cancer in the differential diagnosis of orbital masses and underscores the poor prognosis associated with such atypical metastatic presentations. A review of the literature is provided to place this case within the broader context of orbital metastases of digestive origin.