Unilateral Proptosis as the Presenting Feature of Papillary Thyroid Carcinoma

A 69-year-old female with unilateral proptosis for 1 year presented at our ophthalmology clinic. She had degenerative myopia and a history of low vision for several years. A radiographic imaging revealed a right orbital mass causing bone lysis and invading the intracranial space. Total resection of the mass was performed, and the findings of a histopathological examination were consistent with those for follicular or papillary thyroid carcinoma. Total thyroidectomy with modified radical lymph node dissection revealed a follicular variant of papillary carcinoma. The patient was referred to the nuclear medicine department for further radioiodine therapy. Although extremely rare. thyroid should be carefully examined as a part of the systemic workup when assessing the primary diagnosis of orbital metastasis. Further. patients with pathologic myopia should be carefully examined for signs of orbital mass when suspected because of overlapping symptoms, such as pseudoproptosis and low vision