2nd International Conference on Ophthalmology & Vision Science
August 04, 2025 | Virtual Event
Megan M. Tran
University of Pennsylvania,, USA
Background: Orbital metastases are rare, occurring in 2–5% of systemic malignancies, and
are exceptionally uncommon from testicular germ cell tumors (GCTs). Diagnosis is often delayed,
as symptoms are nonspecific and precede primary cancer diagnosis in up to 32% of
cases. No prior report has described orbital metastasis secondary to a testicular GCT arising
from a teratoma.
Case: We present a novel case of a 21-year-old male with widespread metastatic testicular
GCT involving the skull base, orbit, and optic canal, who developed acute, vision-threatening
compressive optic neuropathy. After initial orchiectomy at outside hospital and liver biopsy on
hospital day 8, initiation of oncologic therapy was delayed pending final pathology. Given a
reassuring early ophthalmologic exam and suspected diagnosis of embryonal carcinoma—a
chemosensitive tumor—surgical resection was initially deferred. However, daily ophthalmic
monitoring revealed rapid visual decline by hospital day 20, prompting emergent multidisciplinary
approach with orbitotomy and craniotomy for mass debulking and optic nerve decompression.
Postoperative exams demonstrated immediate and sustained visual improvement.
Molecular testing was concerning for medulloblastoma arising from a teratoma.
Conclusion: This is the first reported case of orbital metastasis from a testicular GCT of teratomatous
origin, which required emergent surgical decompression for vision preservation. The
case demonstrates the importance of comprehensive systemic evaluation, including of the
genitourinary tract, in young men with nonspecific orbital symptoms. Also, close ophthalmic
monitoring during diagnostic workup is essential to detect rapid visual decline and allow for
timely surgical intervention in the setting of metastatic disease.
Megan is a second-year medical student at the Perelman School of Medicine, University of Pennsylvania, who
aspires to be an ophthalmologist