Isolated metastatic tumors to the optic nerve are extremely rare. We describe a rare and unusual case of metastatic breast carcinoma to the optic nerve that mimicked an optic nerve sheath meningioma in its presentation due to its indolent symptom progression, initial radiological appearance, and minimal growth on serial imaging. The patient, a 46-year-old woman with a history of stable metastatic breast carcinoma, presented with progressive visual loss in her right eye over a 6-month interval. Magnetic resonance imaging revealed an enhancing lesion in the optic canal with an extension to the right anterior clinoid process and planum sphenoidale and into the right orbital apex, consistent with the presumptive diagnosis of optic nerve sheath meningioma. The tumor was resected and pathologically confirmed to be metastatic carcinoma of the breast. The clinical course, radiological features, surgical approach, and treatment strategies are reviewed.KEYWORDS: Breast carcinoma, metastatic disease, ocular metastasis, optic nerve tumor, optic nerve sheath meningioma Carcinoma metastatic to the eye is rare. 1The reported incidence of ocular metastasis varies from 0.07 to 12%. The most frequently involved location is the uveal tract, particularly the posterior temporal choroid. [2][3][4][5][6][7] Metastases to the optic nerve occur far less frequently than ocular metastases. In a series of 227 patients with ocular metastasis, orbital metastasis, or both, Ferry and Font 3 reported that Skull Base, volume 15, number 4, 2005. Address for correspondence and reprint requests:

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Objective: Evaluate quality of life as well as quality of voice before and after endoscopic injection augmentation with Polydimethylsiloxane (VOX-Implants) for unilateral neurogenic vocal fold immobility.Method: Prospective study. Evaluation of 14 patients undergoing injection laryngoplasty (VOX-Implants) under general anesthesia. Evaluation of the following parameters concerning the patients voice (preoperatively, postoperatively): glottic closure (videostroboscopic and flexible-videoendoscopic), voice range profile, maximum phonation time, Dysphonia index (according to Friedrich) and Roughness-Breathiness-Hoarseness-Scale (RBH-Scale). Quality of life was assessed using Voice-Handicap-Index (VHI-12).

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Poster Presentations P149 POSTERSConclusion: There are gaps in AI knowledge of H&N cancer risk factors and early symptoms, particularly regarding the role of HPV. These results highlight the need for further public education. Community-based H&N cancer screening in the AI community is an effective means to identify early findings in smokers.