Orbital metastasis from thigh myxoid/round cell liposarcoma: a rare case report

Myxoid/round cell liposarcoma (MRCLS), a high-grade subtype of myxoid liposarcoma (MLS), accounts for 20–25% of liposarcomas (LSs). While pulmonary metastases predominate, orbital involvement is exceedingly rare and clinically challenging. A 37-year-old male presented with a three-week history of right-sided exophthalmos and diplopia. His medical history was notable for MRCLS of the right thigh, treated with surgery, radiotherapy, and doxorubicin-based chemotherapy. Imaging demonstrated a right orbital mass, confirmed histologically as metastatic MRCLS. Rapid progression led to vision loss and severe pain. Additional metastases were identified in the presacral region and left pleura. Palliative ifosfamide failed to control orbital growth; orbital exenteration provided pain relief and cosmetic improvement. MRCLS may metastasize to the orbit within two years and exhibit aggressive behaviour. Clinicians should consider atypical metastatic spread in patients with a history of soft-tissue sarcoma presenting with orbital symptoms.