Retro-orbital metastasis from differentiated thyroid carcinoma in a radioiodine therapy-naïve patient: any lesson learned?

OBJECTIVE

To present the case of a radioiodine therapy-naïve thyroid cancer patient with postthyroidectomy diplopia.

CLINICAL PRESENTATION AND INTERVENTION: A 63-year-old male patient presented with goiter. Histology performed after thyroidectomy proved follicular thyroid cancer. Without (131)I therapy, diplopia occurred from metastasis to the right medial rectus muscle. Improvement followed after one therapy dose of (131)I.

CONCLUSION

Postoperative radioiodine was important in managing this patient with differentiated thyroid cancer. This case showed that retro-orbital metastasis should be considered as a differential diagnosis in a patient with thyroid cancer who presents with unilateral diplopia.