Fig. 21

Two different patients with orbital metastases. a – c. 74-year-old female patient with diplopia and a history of melanoma of the scalp 7 years previously. T2W (a), unenhanced FS T1W (b) and contrast-enhanced FS T1W (c) images of the orbits shows a conal-extraconal mass in the left orbit (arrows) and a second mass with similar imaging features in the suprazygomatic right masticator space (short arrows). The strongly hyperintense signal in b (arrows) suggests the presence of haemorrhage and/or melanin. Imaging findings are strongly suggestive of metastases from melanoma. Findings were confirmed by biopsy. d – f. 71-year-old female patient with known breast cancer. d. Axial CECT image shows a well-circumscribed enhancing mass in the left orbit in extraconal location (arrow). e. Coronal STIR image of the same patient shows non-specific moderately high signal of the metastatic deposit (thick arrow). Thin arrow points to the left optic nerve. f. Axial PET/CT image of the same patient shows physiological high FDG uptake in the extra-ocular muscles making it difficult to detect the metastatic lesion (arrow). As the imaging findings in this case are non-specific, the diagnosis of orbital metastasis can be suggested only when the clinical background is known. Biopsy confirmed metastasis from breast cancer