{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T19:40:01Z","timestamp":1756323601959,"version":"3.44.0"},"reference-count":35,"publisher":"BMJ","issue":"8","funder":[{"DOI":"10.13039\/100000053","name":"National Eye Institute","doi-asserted-by":"publisher","award":["P30 EY002162"],"award-info":[{"award-number":["P30 EY002162"]}],"id":[{"id":"10.13039\/100000053","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,7,23]]},"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:p>A man in his 70s presented with painless bilateral eyelid oedema and vertical diplopia. Evaluation showed a restrictive pattern of extraocular motility testing with MRI demonstrating significant enlargement of the right superior rectus and left superior oblique muscles along with right orbital fat stranding. Subsequent right orbital biopsy revealed poorly differentiated high-grade neuroendocrine carcinoma without a systemic primary site on further diagnostic workup. The patient was treated with carboplatin and etoposide and passed away from an infection a month after diagnosis. This case along with a review of other published cases highlights the varied presentation of orbital neuroendocrine carcinomas that may mimic a broad differential of orbital processes, thus requiring careful diagnostic workup. Subsequently, additional considerations in metastatic evaluation should be based on tumour histological features.<\/jats:p>","DOI":"10.1136\/bcr-2023-254844","type":"journal-article","created":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T12:10:44Z","timestamp":1693397444000},"page":"e254844","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Poorly differentiated orbital neuroendocrine carcinoma"],"prefix":"10.1136","volume":"16","author":[{"given":"Yi Stephanie","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA"},{"name":"Department of Ophthalmology, San Francisco VA Health Care System, San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marycon","family":"Jiro","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA"},{"name":"Department of Ophthalmology, San Francisco VA Health Care System, San Francisco, California, USA"},{"name":"School of Medicine, University of California San Francisco, San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melike","family":"Pekmezci","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA"},{"name":"Department of Pathology, San Francisco VA Health Care System, San Francisco, California, USA"},{"name":"Department of Pathology, University of California San Francisco, San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5609-3723","authenticated-orcid":false,"given":"Bryan","family":"Winn","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA"},{"name":"Department of Ophthalmology, San Francisco VA Health Care System, San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,8,30]]},"reference":[{"key":"2025082712000656000_16.8.e254844.1","doi-asserted-by":"publisher","DOI":"10.1038\/s41379-018-0110-y"},{"key":"2025082712000656000_16.8.e254844.2","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2008-0207"},{"key":"2025082712000656000_16.8.e254844.3","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.12229"},{"key":"2025082712000656000_16.8.e254844.4","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1148\/rg.351140050","article-title":"Extrapulmonary small cell carcinoma: imaging features with Radiologic-pathologic correlation","volume":"35","author":"Berniker","year":"2015","journal-title":"Radiographics"},{"key":"2025082712000656000_16.8.e254844.5","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/j.sjopt.2018.07.003","article-title":"Small cell Neuroendocrine carcinoma of the orbit presenting as an orbital abscess in a young female","volume":"33","author":"Mittal","year":"2019","journal-title":"Saudi J Ophthalmol"},{"key":"2025082712000656000_16.8.e254844.6","doi-asserted-by":"crossref","first-page":"59","DOI":"10.2143\/ACB.68.1.2062722","article-title":"Bilateral orbital metastases from small cell lung cancer: a case report","volume":"68","author":"Tezcan","year":"2013","journal-title":"Acta Clinica Belgica"},{"key":"2025082712000656000_16.8.e254844.7","unstructured":"Parra-Medina R , Alexander M , Romero-Rojas AE . Bilateral invasive orbital metastases from a poorly differentiated large cell Neuroendocrine carcinoma of the esophagus. 2018;2:5."},{"key":"2025082712000656000_16.8.e254844.8","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2016-217319","article-title":"Diagnosis and treatment of a rare Sinonasal Neuroendocrine tumour: adding to the evidence","volume":"2016","author":"Gudlavalleti","year":"2016","journal-title":"BMJ Case Rep"},{"key":"2025082712000656000_16.8.e254844.9","doi-asserted-by":"crossref","first-page":"e2","DOI":"10.1097\/IOP.0000000000002052","article-title":"Small cell Neuroendocrine carcinoma presenting as recurrent Dacryocystitis: case report of a rare entity","volume":"38","author":"Amjad","year":"2022","journal-title":"Ophthalmic Plast Reconstr Surg"},{"key":"2025082712000656000_16.8.e254844.10","doi-asserted-by":"crossref","first-page":"861","DOI":"10.3341\/jkos.2018.59.9.861","article-title":"Poorly differentiated Neuroendocrine carcinoma of the eyelid","volume":"59","author":"Cho","year":"2018","journal-title":"J Korean Ophthalmol Soc"},{"key":"2025082712000656000_16.8.e254844.11","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0b013e3181ebb56f"},{"key":"2025082712000656000_16.8.e254844.12","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.121.4.491"},{"key":"2025082712000656000_16.8.e254844.13","doi-asserted-by":"crossref","first-page":"94","DOI":"10.4274\/tjo.80688","article-title":"Thyroid-associated Ophthalmopathy","volume":"47","author":"\u015eahl\u0131","year":"2017","journal-title":"Turk J Ophthalmol"},{"key":"2025082712000656000_16.8.e254844.14","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1097\/ICU.0000000000000395","article-title":"Diagnosis of enlarged extraocular muscles: when and how to biopsy","volume":"28","author":"Mombaerts","year":"2017","journal-title":"Curr Opin Ophthalmol"},{"key":"2025082712000656000_16.8.e254844.15","doi-asserted-by":"crossref","first-page":"2347","DOI":"10.1016\/j.joms.2011.10.034","article-title":"Extrapulmonary small cell Neuroendocrine carcinoma of the Paranasal sinuses: a case report and review of the literature","volume":"70","author":"Han","year":"2012","journal-title":"J Oral Maxillofac Surg"},{"key":"2025082712000656000_16.8.e254844.16","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/j.ijscr.2020.12.049","article-title":"An early orbital metastasis from breast cancer: A case report","volume":"78","author":"Razem","year":"2021","journal-title":"Int J Surg Case Rep"},{"key":"2025082712000656000_16.8.e254844.17","doi-asserted-by":"crossref","first-page":"197","DOI":"10.3109\/01676830.2013.772209","article-title":"Small cell Neuroendocrine carcinoma masquerading as Cellulitis and causing blindness via bilateral orbital involvement","volume":"32","author":"Atik","year":"2013","journal-title":"Orbit"},{"key":"2025082712000656000_16.8.e254844.18","article-title":"An extremely rare case of advanced metastatic small cell Neuroendocrine carcinoma of Sinonasal tract","volume":"2016","author":"Thar","year":"2016","journal-title":"Case Rep Oncol Med"},{"key":"2025082712000656000_16.8.e254844.19","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.mpdhp.2020.01.006","article-title":"Primary Sinonasal Neuroendocrine carcinoma invading the orbit","volume":"26","author":"Krishna","year":"2020","journal-title":"Diagnostic Histopathology"},{"key":"2025082712000656000_16.8.e254844.20","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1177\/0145561320964640","article-title":"Sinonasal small cell carcinoma-case series of a rare malignancy","volume":"101","author":"Chapurin","year":"2022","journal-title":"Ear Nose Throat J"},{"key":"2025082712000656000_16.8.e254844.21","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1097\/IOP.0b013e31817cfe50","article-title":"Small cell Neuroendocrine carcinoma of the eyelid","volume":"24","author":"Silkiss","year":"2008","journal-title":"Ophthalmic Plast Reconstr Surg"},{"key":"2025082712000656000_16.8.e254844.22","doi-asserted-by":"crossref","first-page":"422","DOI":"10.5935\/0004-2749.20190081","article-title":"Bilateral metastases to the extraocular muscles from small cell lung carcinoma","volume":"82","author":"Crisostomo","year":"2019","journal-title":"Arq Bras Oftalmol"},{"key":"2025082712000656000_16.8.e254844.23","doi-asserted-by":"crossref","first-page":"104","DOI":"10.4103\/ijc.IJC_820_19","article-title":"Mediastinal small cell carcinoma with a metastasis to the orbit: A rare carcinoma with an unusual metastatic progression","volume":"58","author":"Bolukbas","year":"2021","journal-title":"Indian J Cancer"},{"key":"2025082712000656000_16.8.e254844.24","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.81.5.386"},{"key":"2025082712000656000_16.8.e254844.25","article-title":"Primary Neuroendocrine carcinoma of ocular Adnexa","volume":"2013","author":"Yamanouchi","year":"2013","journal-title":"Case Rep Ophthalmol Med"},{"key":"2025082712000656000_16.8.e254844.26","doi-asserted-by":"publisher","DOI":"10.1159\/000443172"},{"key":"2025082712000656000_16.8.e254844.27","doi-asserted-by":"crossref","first-page":"R219","DOI":"10.1530\/ERC-19-0483","article-title":"Extrapulmonary poorly differentiated Necs, including molecular and immune aspects","volume":"27","author":"McNamara","year":"2020","journal-title":"Endocr Relat Cancer"},{"key":"2025082712000656000_16.8.e254844.28","doi-asserted-by":"crossref","first-page":"149","DOI":"10.2152\/jmi.60.149","article-title":"Imprint cytological feature of large cell Neuroendocrine carcinoma of the gallbladder: a case report","volume":"60","author":"Nakagawa","year":"2013","journal-title":"J Med Invest"},{"key":"2025082712000656000_16.8.e254844.29","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1001\/jamaoncol.2020.8072","article-title":"Current treatment strategies and future directions for Extrapulmonary Neuroendocrine Carcinomas: A review","volume":"7","author":"Stelwagen","year":"2021","journal-title":"JAMA Oncol"},{"key":"2025082712000656000_16.8.e254844.30","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.ejim.2007.03.011","article-title":"Orbital metastasis as the presenting symptom of extensive stage small cell lung cancer","volume":"19","author":"Henning","year":"2008","journal-title":"Eur J Intern Med"},{"key":"2025082712000656000_16.8.e254844.31","doi-asserted-by":"crossref","first-page":"430","DOI":"10.12688\/f1000research.11247.1","article-title":"Case report: orbital metastasis as the presenting feature of lung cancer","volume":"6","author":"Munakomi","year":"2017","journal-title":"F1000Res"},{"key":"2025082712000656000_16.8.e254844.32","doi-asserted-by":"crossref","first-page":"e22","DOI":"10.1016\/j.jcjo.2017.06.017","article-title":"Orbital metastatic small cell carcinoma of the Pancreas with optic nerve compression","volume":"53","author":"Rong","year":"2018","journal-title":"Can J Ophthalmol"},{"key":"2025082712000656000_16.8.e254844.33","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1007\/s12070-008-0061-6","article-title":"Sinonasal neuro endocrine carcinoma extending into orbit \u2014 a case report","volume":"60","author":"Renuka","year":"2008","journal-title":"Indian J Otolaryngol Head Neck Surg"},{"key":"2025082712000656000_16.8.e254844.34","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1590\/0100-3984.2016.0184","article-title":"Poorly differentiated large-cell Neuroendocrine carcinoma of the Paranasal sinus","volume":"51","author":"Campos","year":"2018","journal-title":"Radiol Bras"},{"key":"2025082712000656000_16.8.e254844.35","first-page":"106","article-title":"Primary Neuroendocrine carcinoma at an unusual site","volume":"9","author":"Mathew","year":"2020","journal-title":"GCSMC J Med Sci"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2023-254844","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T19:00:15Z","timestamp":1756321215000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2023-254844"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8]]},"references-count":35,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,8,30]]},"published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1136\/bcr-2023-254844"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2023-254844","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2023,8]]}}}