DIFFUSE BILATERAL ORBITAL METASTASIS OF BREAST CANCER: A CASE REPORT
Author: Batuhan Aksoy
Base Hospital / Institution: Istanbul University-Cerrahpaşa Faculty Of Medicine
ePoster presentation
Abstract ID: 24-398
Purpose
Orbital metastases from solid tumours are rare or underestimated. Common signs and symptoms include proptosis, diplopia, pain and reduced visual acuity. Of all the tumours that metastasise to the orbit, breast cancer is considered to be the most common primary tumour.Breast cancer may present bilaterally in up to 15-20% of cases, unlike other orbital metastases.
Methods
We report the case of a 65-year-old female patient with metastatic breast cancer with a new complaint of diplopia. Ophthalmological examination revealed bilateral pupillary direct and indirect light reflexes were positive. Bilateral globe movements were limited in abduction and elevation and binocular diplopia was present in nine quadrants. According to log MAR, best corrected visual acuity of the both eyes is 0. Bilateral slit lamp and fundoscopic examination were normal.Orbital imaging revealed lesions compatible with metastasis infiltrating the rectus muscle walls surrounding the optic nerve in bilateral fatty planes. The patient underwent right orbitotomy and multiple biopsies were taken. The pathology report was compatible with breast cancer.Then the patient was transferred to oncology department for systemic treatment.
Results
Involvement of the extraocular muscles by metastases from distant sites is rare and this is an indication of systematic spread as in our patient. Treatment is usually palliative and prognoses are usually poor.The 5-year survival rate of patients with metastatic breast cancer is approximately 20%, but the median survival time after diagnosis of orbital metastases from breast cancer is approximately 2 years and requires systemic treatment depending on the overall burden of the disease.
Conclusion
Orbital metastases from breast cancer are associated with significant morbidity.Given that a half of patients with orbital breast metastasis present with infiltrative or inflammatory signs, metastatic breast cancer must be included in the differential diagnosis of inflammatory and infiltrative orbital processes in adult female patients in order to establish an accurate diagnosis and provide appropriate therapy.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| AHMET MURAT | SARICI | Istanbul University-Cerrahpaşa Faculty Of Medicine |
| SENIHE RENGIN | YILDIRIM | Istanbul University-Cerrahpaşa Faculty Of Medicine |
