Metastatic Neoplasms in the Optic Disc

Shields, Jerry A.

doi:10.1001/archopht.118.2.217

Cited by 87 publications

(38 citation statements)

References 22 publications

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“…Bilateral involvement may mimic papilloedema (Shields et al 1992). In their retrospective study of 660 patients with intraocular metastasis, Shields et al (2000) found that optic nerve head involvement accounted for 5% of all intraocular metastases. Ophthalmoscopically, disc metastasis appeared as a diffuse enlargement of the optic disc in 84% and a distinct nodule in 16% of cases.…”

Section: Other Intraocular Sitesmentioning

confidence: 99%

Ocular presentations of breast cancer

Wickremasinghe

Dansingani

Tranos

et al. 2006

Acta Ophthalmologica Scandinavica

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IntroductionBreast cancer is the most common malignancy in women (Office of National Statistics 2002). As ophthalmic manifestations are common, the astute ophthalmologist can instigate the search for primary disease when the first presentation is ophthalmic in nature, or, alternatively, play an important role in detecting the metastatic spread of a known primary. Breast cancer accounts for 29% of new malignancies in women in the UK and is a major cause of mortality and morbidity worldwide.The purpose of this article is to provide a review of the ophthalmic manifestations of breast cancer. The subjects covered include the presenting features of metastatic disease involving the visual systems, treatment modalities and strategies currently available, and the ocular effects and complications of treatment. EpidemiologyIncidence rates of breast cancer have increased over the last decade, rising from 90 to 130 per 100 000 population (1988 versus 1998) (Office of National Statistics 2002). In contrast, mortality rates have remained relatively stable since the 1950s. This increase in the incidence of breast cancer is attributed to more effective screening programmes, although a change in the demographics of developed countries and an increasing elderly population may contribute to the growing incidence. Geographical variations exist in breast cancer incidence rates, with higher rates in Europe, North America and Oceania and lower rates in Asia and Africa (Sasco 2001). Doctors practising in the western world should be familiar with the disease.Male breast cancer is rare. The incidence is 0.8-1.5 cases per 100 000 male population, accounting for 1% of all breast cancer diagnoses (Office of National Statistics 2002; Hodgson et al. 2004). The highest incidence occurs in men aged over 70 years (Kidmas et al. 2005). In families with hereditary breast cancer, younger males may be affected. The BRCA2 gene is often implicated in these cases (Lorenzo Bermejo & Hemminki 2005).Ocular manifestations of male breast cancer can occur and this differential diagnosis should not be overlooked (O'Brien et al. 2000;Silvestris et al. 2003;Dieing et al. 2004). Ophthalmic metastases in breast cancerMetastatic disease to the eye from the breast was first described by Johann ABSTRACT.Context: Breast cancer is the most common malignancy in women, with increasing incidence in Europe and North America. The frequency of involvement of the eye and visual pathways is reported to be as high as 30% in patients with known metastatic disease. In some cases, ophthalmic involvement can be the first sign of metastatic spread. Metastasis occurs via the haematogenous route and predominantly involves the choroid. Metastases to other ocular structures, the orbit and the visual pathways have also been described. Paraneoplastic effects are rare but significant. Treatments: Different modalities are employed in the treatment of breast cancer and its metastases. These include chemotherapy and radiotherapy. The ocular adverse effects of these have been well described,...

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Section: Other Intraocular Sitesmentioning

confidence: 99%

Ocular presentations of breast cancer

Wickremasinghe

Dansingani

Tranos

et al. 2006

Acta Ophthalmologica Scandinavica

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“…Most previously reported cases with metastatic optic nerve tumours showed choroidal invasion [2,4,7], while a few have been reported without evidence of choroidal lesions [2][3][4][5][6][7][8]. Isolated metastasis to the optic disc is extremely rare, with a reported incidence among intraocular metastases ranging from 1.2 to 4%.…”

Section: Discussionmentioning

confidence: 99%

“…Shields et al reported only eight cases of isolated optic nerve metastasis without retinal or choroidal involvement in a series of 660 patients with intraocular metastasis [2]. Also, to the best of our knowledge, histopathological results of metastatic optic nerve tumors have been reported in only a few studies, which were based on autopsy, eyeball enucleation, and fine needle biopsy findings [2][3][4][5][6][7][8]. Herein, we report a case of metastasis from primary lung cancer to the optic disc without involvement of a juxtapapillary choroidal component.…”

Section: Introductionmentioning

confidence: 99%

Case of metastatic pulmonary carcinoma in optic disc diagnosed from results of biopsy performed during vitrectomy surgery

Fukuda

Tanabe

Sawamura

et al. 2011

Graefes Arch Clin Exp Ophthalmol

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“…The incidence of ocular metastasis from breast cancer ranges between 5% -30% [1] [2], with a 37% of microscopic uveal affectation [2], whereas only 4.5% of all intraocular metastasis develop in the optic nerve, 43% of them coming from a primary breast neoplasia [3].…”

Section: Introductionmentioning

confidence: 99%

Optic Nerve Metastasis from Breast Carcinoma after Treatment with Taxanes

Durán¹,

Vallejo-Garcia²,

Rodriguez-Rodriguez³

et al. 2014

CRCM

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Introduction: The incidence of ocular metastasis from Breast Carcinoma is only between 5% -30%, mainly located in choroid, but the location in optic nerve is even more infrequent. We present a rare case that combined both locations sequentially in the same eye. Methods: Case report. Results: A 58-year-old woman with advanced breast cancer was referred with a choroidal metastasis in her right eye which responded well to systemic Taxol and Avastin. Afterwards, she developed an optic nerve metastasis in the same eye when she was under the treatment, so it was changed to Docetaxel. Unfortunately the patient didn't respond to this treatment and died. Conclusions: Choroidal metastasis secondary to breast cancer generally responds well to radiotherapy. Even so, in cases that a great deterioration of visual acuity is expected after radiation, chemotherapy like taxanes is an alternative to preserve vision with complete tumor regression. Nevertheless, the presentation of a second metastasis in optic nerve can be indicative of inadequate treatment of metastatic disease or complication of the treatment, or both.

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Metastatic Neoplasms in the Optic Disc

Cited by 87 publications

References 22 publications

Ocular presentations of breast cancer

Ocular presentations of breast cancer

Case of metastatic pulmonary carcinoma in optic disc diagnosed from results of biopsy performed during vitrectomy surgery

Optic Nerve Metastasis from Breast Carcinoma after Treatment with Taxanes

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