Bilateral multiple extraocular muscle metastasis from breast carcinoma

Abstract

We report a rare presentation of an initially misdiagnosed case of a pseudotumor, which on histopathology was diagnosed as bilateral breast metastases of lobular carcinoma involving multiple extraocular muscles. A 61-year-old lady presented with external ophthalmoplegia and diplopia. Incisional biopsy was performed using a lid crease approach and the patient received radiotherapy and hormonal therapy. Following prolonged hormonal therapy, complete remission was achieved, with improvement in ocular motility and resolution of diplopia, about 18 months after the initial presentation. Multiple extraocular muscle involvement by breast carcinoma metastasis is very rare and should be considered in the differential diagnosis, especially in patients with a prior history of breast carcinoma.

Keywords

• Pediatric traumatic cataract
• primary posterior capsulotomy
• posterior capsule opacification
• square-edge intraocular lens
• visual axis opacification
• Multifocal electroretinogram
• principal components′
• analysis
• retinitis pigmentosa
• Behcet′s disease
• HLA-B51
• optical coherence tomography
• macular hole
• Graves′ ophthalmopathy
• thyroid eye disease
• unilateral
• Assam
• corneal ulcer
• fusarium
• mycotic keratitis
• Antifungal sensitivity testing
• amphotericin B
• Aspergillus
• fungal keratitis
• polymerase chain reaction--single-stranded conformational polymorphism.
• Lid coloboma
• limbal dermoid
• nasopalpebral lipoma-coloboma syndrome
• Bilateral
• breast metastasis
• extraocular muscle