Metastatic breast cancer: an unusual cause of diplopia

Abstract

While secondary solid cancer into the eye orbit is rare, it is the most common site for primary metastasis in female breast cancer. We report a case of a sixty-six years old woman presenting to her optician with complaints of double vision. Magnetic resonance imaging revealed an invasive lesion in the superior and medial rectus muscles of the right orbit, biopsy of which confirmed this as an infiltrating breast carcinoma. Investigation of the primary lesion showed an advanced invasive ductal carcinoma of the right breast. She was then treated with radiotherapy to the orbit and a non steroidal aromatase inhibitor Anastrozol (Arimidex®). We herein review and discuss the literature, epidemiology, mechanism of tumor spread, the "seed and soil" theory, clinical presentation, pathology, and management of this uncommon presentation.

Metastases to extraocular muscles from breast cancer: case report and up-to-date review of the literature

“…Unfortunately, several studies did not provide histological subtypying of BC, treatment details and overall survival data. Twelve patients had extraocular muscle metastases from ILC [ 4 , 14 , 20 , 21 , 23 , 28 , 31 , 38 ], whereas in 5 patients (including our case) IDC was the primary source [ 29 , 34 – 36 ]. Three patients had a poorly differentiated BC, four patients had an undifferentiated BC.…”

Diplopia and Extraocular Muscle Enlargement as an Initial Presentation of Breast Cancer

“…5,8-10 While rare, extraocular metastasis as the initial presentation of breast cancer similar to our patient have been previously described. [11][12][13] Bilateral orbital metastasis is often less frequent than unilateral disease, representing 6 to 25% of cases. 2,8-9 However, bilateral orbit involvement tends to occur more frequently in breast cancer.…”