Nonpalpable Breast Carcinoma Presenting as Orbital Infiltration

Breast cancer is the most common malignant disease among women, with a lifetime risk of approximately 10%. Frequent and well-known locations of metastases are bone, liver, lung, skin and brain, but tumour repetition has been seen in almost any anatomic site. Orbital involvement is quite rare, or perhaps underestimated. Orbit metastases (OMs) represent 1-13% of all orbital cancers, and are difficult to discriminate with other differential diagnoses, such as a simple blepharitis, or orbital pseudotumor, up to more complex forms of cancer such as lymphoma. The prevalence of OMs is calculated to occur in 2-4.7% of primitive cancer patients. Typical manifestations of orbital metastases include overall regional inflammation, mass effect causing displacement or ocular globe proptosis, pain, bone infiltration, chemosis and eyelid swelling. Infiltration of soft tissue leads to ptosis, diplopia or enophthalmos. We report the case of a 70-year-old female patient who developed chronic inflammatory process of both orbital regions due to orbital metastases, without evidence of other systemic disease after 8 years from primary breast cancer diagnosis. The diagnostic pathway as well as the differential diagnosis are discussed.Breast cancer is the most common malignant disease among women, with a lifetime risk of approximately 10%. Men seldom develop this malignancy and represent about 1% of all cases with diagnosis of breast cancer (1). The biological properties and clinical features of breast cancer appear to be similar in both genders. Frequent and well-known locations of metastases are bone, liver, lung, skin and brain, but tumor manifestations have been seen in almost any anatomic site. Orbital involvement is quite rare, or perhaps underestimated (2).Orbit metastases (OMs) represent 1-13% of all orbital tumors and occur in 2-4.7% of patients with primitive cancer (2). Metastases of breast cancer account for the majority of ocular and orbital metastases (3,4).Typical manifestations of OMs include mass effect causing displacement or proptosis of the ocular globe, pain, inflammation, bone infiltration,

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“…In 12-31% of cases, orbits may be the first location of a neoplastic form or its dissemination (1O, [13][14][15].…”

Section: Discussionmentioning

confidence: 99%

Orbital Metastases in a Female Patient with Breast Cancer

et al. 2013

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“…An old theory had it that unilateral periorbital edema was a cutaneous metastasis of breast malignancy, because 69% of women with skin metastases had breast tumors as the primary malignancy. [12][13][14] Mammary metastasis to the eyelid has been reported in a few cases, and its usual manifestations are erythematous induration, nodularity, and even discrete fl esh nodules. [11][12][13] Although we did not fi nd any malignancy in the biopsy specimen of the eyelid, it is important to consider the possibility of eyelid metastasis in this patient.…”

Section: Discussionmentioning

confidence: 99%

Metastatic carcinoma of the breast: A case with the unusual presentation of unilateral periorbital edema

Kuo

Hsiao

Chiou³

et al. 2008

Jpn J Ophthalmol

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“…Here we report two cases of slowly progressing metastatic breast cancer that were initially presented to an ophthalmologist. Although eye metastases are relatively rare as the fi rst signs of the metastatic disease [2][3][4][5][6], we intend to draw attention to such cases, because specifi c intervention may well control the ocular symptoms [7][8][9][10][11].…”

Section: Discussionmentioning

confidence: 99%

Ocular abnormality as the first sign of metastatic breast cancer: the presentation of two cases

Kahán

Szabó

Cserháti

2008

memo

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Breast cancer patients occasionally present with ocular symptoms which may be the fi rst sign of metastatic disease. One patient presents with choroidal metastasis and resulting retinal ablation and the other patient with orbital manifestation and resulting exophthalmos. In both cases, metastatic involvement of multiple organs was detected. Oncological therapies resulted in tumour regression and reduced ocular symptoms. Since specifi c treatment may control intraocular or intraorbital manifestations, thorough ophthalmological examination is mandatory in cancer patients with ocular symp toms. memo magazine of european medical oncology memo Ocular abnormality as the fi rst sign of metastatic breast cancer 3/2008 case report 153

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Nonpalpable Breast Carcinoma Presenting as Orbital Infiltration

Abstract: This is a rare case of an orbital metastatic adenocarcinoma preceding the diagnosis of a nonpalpable primary breast carcinoma.

Cited by 40 publications

References 12 publications

Orbital Metastases in a Female Patient with Breast Cancer

Orbital Metastases in a Female Patient with Breast Cancer

Metastatic carcinoma of the breast: A case with the unusual presentation of unilateral periorbital edema

Ocular abnormality as the first sign of metastatic breast cancer: the presentation of two cases

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