Orbital Metastasis of Cervical Squamous Cell Cancer during Treatment with Pembrolizumab

Orbital Metastasis of Cervical Squamous Cell Cancer during Treatment with Pembrolizumab

Purpose: This case report presents a rare occurrence of squamous cell carcinoma metastasizing to the orbit from the cervix. Case summary: A 48-year-old female with cervical cancer and multiple bone metastases experienced binocular diplopia two days prior to admission to the Department of Gynecology for scheduled chemotherapy. She was undergoing treatment with pembrolizumab, a programmed cell death protein 1 (PD-1) inhibitor, for metastatic cervical cancer. The patient exhibited unilateral ptosis and restricted eyeball movement in the right eye. Brain MRI revealed a well-defined lobulated lesion attached to the superior rectus muscle in the right orbit and orbital apex. In suspicion of metastasis, radiation therapy with a dosage of 3,600 cGy was administered to the right orbital area, resulting in a reduction in size of the metastatic lesion. However, distant metastases subsequently developed in the bone and soft tissue, leading to the patient's demise one month later. Conclusions: This report emphasizes the importance of considering orbital metastasis from cervical cancer in patients undergoing advanced stage chemotherapy. It highlights the rarity of such cases and underscores the need for heightened awareness of this malignancy in patients with underlying cancer.