Orbital Apex Syndrome as a Sign of Unsuspected Breast Carcinoma

Abstract

Breast cancer, the most common form of cancer among women, rarely metastasizes to the paranasal sinuses and skull base. The disease usually proceeds insidiously, remaining asymptomatic until ocular symptoms appear. Orbital involvement is frequently seen in metastatic disease of the paranasal sinuses and skull base, but orbital apex syndrome is rare. Early presentation with clinical features of acute ethmoiditis can delay the diagnosis of metastatic disease. Here, we report the case of a 43-year-old woman with breast cancer who presented with orbital apex syndrome secondary to the skull base and paranasal sinus metastasis.

Rare metastasis to paranasal sinuses from triple-negative breast cancer

“…In the published reports of breast carcinoma metastasis to paranasal sinuses, the treatments were generally palliative with the aim of relieving symptoms, and no systemic treatment was adopted in most of these reports. [ 2 , 6 ] Radiotherapy is the standard treatment, and some patients may benefit from chemotherapy or hormone therapy. [ 7 ] Surgical resection can be helpful in some patients.…”

“…Metastasis to the head and neck region is extremely rare, with only 6 reported cases in the literature. [ 2 – 7 ] In these cases, most patients did not receive any systemic treatment and had a very poor prognosis. Here, we present a recent case of triple-negative breast cancer, the most malignant type of breast cancer, metastasis to the sphenoid sinuses.…”

Metastatic breast carcinoma of the jugular foramen: A rare case of Villaret syndrome

“…Although metastases of breast cancer to the head and neck region is rare, breast cancer is the most common subclavicular primary site to metastasize to the skull base . Metastasis of breast cancer to the orbit has been well described and several cases of occipital condyle syndrome because of breast cancer metastases have been reported . Though only 1% of parasellar and sellar tumors are due to metastases, breast cancer accounts for 40% of these tumors .…”

Vertigo by Breast Cancer Metastasis 33 Years after Treatment

“…Although rare, there are various reports on metastasis of carcinoma, and five common skull base metastatic sites include the orbit, parasellar area, middle fossa, jugular foramen, and occipital condyle with accompanying symptoms. Clinical features due to the progressive ipsilateral involvement of the cranial nerves include headache, ophthalmoplegia, facial numbness, and hoarseness (7)(8)(9)(10). Nasal bleeding has also been reported.…”