Orbital Metastases in a Female Patient with Breast Cancer

Abstract

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.