Description of the clinical case:

A 67-year-old man with history of radical cystectomy due to a muscle-invasive bladder tumor presented with an acute erythema and swelling in the left periorbital region accompanied by tenderness and decreased ocular motility. Initially, a periorbital cellulitis was suspected and empirical antibiotics treatment with initiated. As there was no improvement with the antibiotic regimen, it was decided to biopsy the lesion. The biopsy results were consistent with metastasis of bladder carcinoma.

Relevance:

Bladder carcinoma represents one of the most common urological tumors, affecting predominantly males. The most frequent sites of metastasis are the lymph nodes, lungs, and bones; metastatic involvement of the orbit by bladder carcinoma is rare.

Clinical implications:

Although metastatic involvement of the orbit by urothelial tumors is very rare, it is important to know the characteristics of the lesion in order to make a timely diagnosis and thus provide adequate treatment.

Conclusion:

In patients with a history of bladder cancer who present periorbital cellulitis without improvement of symptoms despite adequate antibiotic treatment, orbital involvement due to bladder tumor metastasis should be suspected.

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