Imaging characteristics of orbital involvement in patients with neuroendocrine neoplasms: a report of two cases

This case series presents clinical and radiological findings of two patients with orbital involvement of neuroendocrine neoplasm (NEN) and discusses imaging characteristics in the context of modern literature. Full ophthalmic examination and orthoptic assessment were completed in two patients. Magnetic resonance imaging of the orbit and brain was carried out using 1.5 Tesla MRI (Siemens Symphony, Erlangen, Germany) Despite different systemic involvement (Patient 1: primary lesion in the caecum, with multiple deposits in the liver, left iliac crest, myocardium, pleura, paratracheal region and paraoesophageal nodes; patient 2: skin and pituitary lesions) in all patients in this case series, orbital MRI showed a lobulated, well-circumscribed lesion adherent or involving extraocular muscles. In both cases, orbital involvement was not isolated. Brain and scalp lesions in patient 2 had similar lobulated heterogeneous appearance. This case series highlights the importance of systemic work-up of patients presenting with NEN to assess for both primary and extent of disease. Multi-disciplinary team involvement is essential to provide patients with a correct diagnosis and appropriate management promptly.