(3) have demonstrated a case of orbital metastasis of PTC to the medial rectus muscle
, similar to our case, in which muscles were involved.
Right medial rectus muscle
was hypertrophic and iso-hyperintense in T2, and contrast-enhanced, fat-suppressed T1-weighted images (Figure 1A, 1B, 1C, 1D).
In the second case, medial rectus muscle
swelling, lid retraction, and proptosis of the right eye and diplopia were observed .
Orbital computed tomography revealed a 1.5 x 2.9 x 1.5 cm rim-enhancing hypodense lesion at the right orbital apex abutting to the optic nerve sheath complex and right medial rectus muscle
It exists in complex with multiple independent subnuclei, controlling the superior, inferior, and medial rectus muscle
, inferior oblique muscle, levator palpebrae superioris muscle, and sphincter pupillae, respectively.
Most involve injury to the medial rectus muscle
via violation of the lamina papyracea, while the orbital floor and adjacent inferior rectus muscle is generally not considered a high-risk area .
The inferior rectus muscle is most commonly affected, followed by the medial rectus muscle
The left medial rectus muscle
was thickened (left medial rectus 6.48 mm, right medial rectus 3.66 mm).
The medial rectus muscle
has it insertion in the medium anterior region of the capsule, getting fixed between the oblique ones, while the lateral rectus one emits muscular fibers, being inserted in the medium posterior region of the sclera and optical cartilage (Fig.
For recession surgery, medial rectus muscle
was detached from the sclera (Figure 2) after used suspensory suture with Vicryl 7-0 (polyglactin 910, Ethicon, USA).
The patient was diagnosed with sixth nerve palsy and 18 months after trauma, he underwent right medial rectus muscle
Local examination revealed a bluish mass with irregular surface and ill-defined margins located in the medial rectus muscle
. The mass became more prominent on dextroversion.