Unusual features of orbital metastases from breast cancer
Author: Matteo Barchitta
Base Hospital / Institution: Tiberia Hospital – GVM care and Research – Rome – Italy
ePoster presentation
Abstract ID: 24-313
Purpose
To analyse the clinical and pathological features of orbital metastases from breast cancer.
Methods
Case reports of 3 consecutive patients with a diagnosis of orbital metastasis from breast cancer who recently presented to a single tertiary institution.
Results
The median age at presentation was 67,6 years. The histology was positive for lobular breast carcinoma in all cases. Case 1: A 56-year-old woman with history of breast cancer operated 16 years before presented with mild pain in her right orbit, horizontal diplopia, and right enophthalmos. CT scan showed thickening of the right medial rectus muscle and no other abnormalities. Biopsy of the affected muscle revealed secondary lobular breast carcinoma. Case 2: A 62-year-old woman presented with left ptosis with incomplete eye closure, severe impairment of eye movements and diffuse orbital pain. CT scan showed diffuse left orbital involvement. There was no known history of breast cancer. Left orbital biopsy was positive for lobular breast carcinoma. The patient underwent a systemic workup, and a small breast nodule was excised with diagnosis of invasive ductal breast carcinoma. Case 3: An 85-year-old woman presented with right ptosis, diplopia, recent onset right periorbital pain, and a palpable right orbital mass. She had breast cancer removal in 1994 and adjuvant chemotherapy, with regular follow-up. CT scan showed a diffuse right orbital mass. Orbital biopsy revealed a lobular breast carcinoma.
Conclusion
Orbital metastases may be the first sign of an undiagnosed primary tumour, mostly invasive lobular breast cancer. Presentation may differ in each case, rarely with the involvement of a single extraocular muscle with no visceral or brain metastases, and may appear up to 29 years after the original tumour diagnosis. Histology of the primary tumour may differ from that of the metastasis. Ophthalmological evaluation should be performed on all patients with known breast cancer and mild ocular symptoms. Early local treatment may help to prevent severe complications andreduces the negative impact on quality of life.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Giulio | Ranazzi | Tiberia Hospital – GVM care and Research – Rome – Italy |
| Francesco | Quaranta Leoni | Tiberia Hospital – GVM care and Research – Rome – Italy |
| Tiberia Hospital – GVM care and Research – Rome – Italy |
