Metastatic breast carcinoma involving the optic disc

Kim, Christian; Pearce, William A.

doi:10.1016/j.ajoc.2020.100698

Cited by 12 publications

(10 citation statements)

References 13 publications

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“…9 OCT features of optic metastasis were only recently reported by Kim and Pearce. 6 They described it as hyperreflective nodular lesion of the optic disc similar to the lesions observed in our case. In our patient, peripapillary choroidal thickening and SRF accumulation around optic disc suggested contiguous choroidal infiltration.…”

Section: Discussionsupporting

confidence: 85%

“…Diagnosis of choroidal and/or optic disc metastasis is based on clinical history and fundus examination, though it has greatly benefited from the contribution and the development of modern multimodal imaging techniques. [5][6][7] CFP and IR showed in this case a large yellow subretinal mass located at the macula and extending beyond the temporal vascular arches and nasally to the optic disc. Uncommon papillary lesions were also noted, associated to optic disc edema probably secondary to the local compression of the tumor.…”

Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 99%

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Optic disc and choroidal metastases secondary to breast cancer: A case report

Bouraoui

Matri

Falfoul

et al. 2021

European Journal of Ophthalmology

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Aim: To report an uncommon case of optic disc and multiple choroidal metastases secondary to breast cancer, assessed with swept source optical coherence tomography (SS-OCT), fluorescein (FA), and infracyanine (ICGA) angiographies. Methods: Observational case report. Case presentation: A 40-year-old woman with history of left breast carcinoma presented with blurred vision in her right eye (RE). Her visual acuity was 1/20 in the RE and 10/10 in the left eye. Fundus examination of the RE showed a large yellowish elevation of the posterior pole and a particular whitish nodular papillary cluster protruding from the optic disc into the vitreous. Infrared imaging enhanced the papillary nodular infiltrates. Characteristic findings of choroidal metastasis were noted within the macular lesion on SS-OCT and ICGA. SS-OCT showed specific “lumpy bumpy” irregularity of the anterior surface of the choroid and elevated hyperreflective nodular lesions of the optic disc associated to peripapillary subretinal fluid. The papillary lesions appeared as a bunch of hypofluorescent dots on both FA and ICGA, and ultra-wide field FA was helpful clearly delimiting the large macular lesion. Besides, comprehensive imaging and especially ICGA could detect two asymptomatic choroidal metastases in a systematic assessment of the fellow eye. Conclusion: Optic disc metastases are extremely rare. Their diagnosis can be easily done on fundus examination when presenting with characteristic whitish cluster nodular infiltrates of the optic disc. However multimodal imaging remains very useful for the assessment of the local extension of the lesion and for diagnosing associated asymptomatic choroidal lesions gone unnoticed at the fundus examination.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 56%

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Optic disc and choroidal metastases secondary to breast cancer: A case report

Bouraoui

Matri

Falfoul

et al. 2021

European Journal of Ophthalmology

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“…Recently published cases [ 20 , 22 , 23 ] showed improvement in treatment outcomes secondary to the implementation of CDK4/6 inhibitors in combination with new RTH techniques like Stereotactic Body Radiotherapy (SBRT) [ 24 ]. Wiegel et al [ 26 ] showed that external beam radiotherapy (EBRTH) leads to stabilised or restored vision in up to 86% of patients; the typical dose varies between 20 and 50 Gy [ 3 , 5 , 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

Eye metastasis in breast cancer: case report and review of literature

Saad¹,

Bakri²,

Ryan³

et al. 2022

ecancer

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The paradigm of breast cancer management has been revolutionised, resulting in prolonged survival that echoes an increasing incidence of metastasis in uncommon sites. With orbital metastases -despite being rare -the incidence scales up to 13% of breast cancer cases with no specific management guidelines. We report a case of a 31-yearold luminal B breast cancer patient who initially presented with T2N2M0 disease and received six cycles of adjuvant chemotherapy (5-Fluorouracil (5-FU) 600 mg/m² IV, Doxorubicin 60 mg/m² IV, Cyclophosphamide 600 mg/m² IV), followed by radiotherapy (RTH) and adjuvant Tamoxifen. Two years later, the patient experienced successive bone metastasis, so she received several lines of endocrine therapy as Fulvestrant and aromatase inhibitors in combination with luteinizing hormone-releasing hormone (LHRH) analogues. Later on, she presented with right eye ptosis and magnetic resonance imaging (MRI) showed a soft tissue mass in the superior and lateral rectus muscles. The patient received six cycles of chemotherapy with no improvement. Further disease progression occurred 3 months later, so the patient received palliative RTH resulting in no response. One month later, the patient was deceased, secondary to progressive disease. With the rising incidence of ocular metastasis due to breast cancer, oncologists should be aware of symptoms and use the proper diagnostic modalities. Here we provide a literature review on similar cases and discuss possible treatment modalities for those patients. The main concern is to evaluate the need for chemotherapy in such cases in the presence of highly effective endocrinal treatment.

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“…The search phrase ‘breast cancer metastasis to the orbit’, ‘metastatic breast cancer to orbit’, and ‘orbital metastasis from breast cancer’ identified 101 cases. 3…”

Section: Methodsmentioning

confidence: 99%

A ‘never miss’ diagnosis: Ptosis secondary to metastatic breast cancer diagnosed as involutional ptosis and a review of the literature

Safi

Fethat

Silkiss

2021

SAGE Open Medical Case Reports

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We present a case of ptosis secondary to metastatic lobular carcinoma of the breast which was initially diagnosed as involutional ptosis. A 67-year-old woman previously diagnosed with lobular carcinoma of the breast presented to our clinic with mild restriction of lateral gaze and persistent droopiness of her right eyelid (associated with decreased levator function) despite recent repair of a suspected involutional ptosis. Orbital magnetic resonance imaging revealed a mass in the right orbit which was biopsied and diagnosed as lobular carcinoma of the breast. Poor levator function is rarely present in involutional ptosis. Especially in conjunction with abnormal extraocular motility, other etiologies of acquired ptosis must be considered. This case highlights the importance of patient history and ocular examination in identifying the underlying etiology of ptosis. A review of the literature to evaluate the incidence of signs and symptoms associated with metastatic breast cancer to the orbit is included.

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Metastatic breast carcinoma involving the optic disc

Cited by 12 publications

References 13 publications

Optic disc and choroidal metastases secondary to breast cancer: A case report

Optic disc and choroidal metastases secondary to breast cancer: A case report

Eye metastasis in breast cancer: case report and review of literature

A ‘never miss’ diagnosis: Ptosis secondary to metastatic breast cancer diagnosed as involutional ptosis and a review of the literature

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