Tamoxifen-Induced Regression of a Choroidal Metastasis in a Man

Cohen, Victoria M L; Moosavi, Reza; Hungerford, J. L.

doi:10.1001/archopht.123.8.1153

Cited by 14 publications

(11 citation statements)

References 4 publications

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“…3 We have seen successful regression of choroidal metastases in a man following treatment with tamoxifen for an oestrogen receptor-positive breast cancer (Figures 1e and f). 15 This has also been reported with the new aromatase inhibitors, which have been developed for post-menopausal women with oestrogen receptor-positive breast cancer. Manquez et al 16 reported that systemic aromatase inhibitors were effective in treating choroidal metastases from breast cancer in 59% of patients, many of whom did not previously respond to tamoxifen.…”

Section: Treatmentmentioning

confidence: 71%

Ocular metastases

Cohen

2012

Eye

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The eye is a rare site for disseminated malignancy because of the absence of a lymphatic system. Metastases to the ocular structures occur by haematogenous spread and therefore the parts of the eye with the best vascular supply are most likely to be affected. Many patients with Stage 4 carcinomatosis (distal metastatic spread) already have a history of a previous primary cancer. However, this is not always the case for lung cancer as this can metastasise early to the uveal tract and therefore the ophthalmologist may be the first to discover the presence of terminal metastatic disease. Broadly speaking, treatment options are focused on improving the patients' quality of life if visual acuity is threatened. Long-term side effects of treatment need to be considered as systemic cancer treatments and therefore patient life expectancy is improving. In this manuscript, presented at the Cambridge symposium 2012, the diagnosis and challenges involved in the management of ocular metastases are presented.

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Section: Treatmentmentioning

confidence: 71%

Ocular metastases

Cohen

2012

Eye

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“…Systemic chemotherapy4 and hormonal therapy5 given for the systemic condition have been reported to cause regression of choroidal metastasis. This obviates the need for ocular intervention like radiotherapy, preventing its side-effects.…”

Section: Discussionmentioning

confidence: 99%

“…This obviates the need for ocular intervention like radiotherapy, preventing its side-effects. Breast carcinoma in males has a higher concentration of estrogen and progesterone receptors than in the female, thus rendering both the primary and the metastasis more susceptible to hormonal manipulation 5. …”

Section: Discussionmentioning

confidence: 99%

Systemic chemotherapy and tamoxifen induced regression of choroidal metastasis from a breast carcinoma in a male

Shome

Jayadev

Gadgil

et al. 2007

Indian J Ophthalmol

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We report a case of a 55-year-old male patient with breast carcinoma, who developed choroidal metastasis. The patient had undergone mastectomy for carcinoma of right breast, five years ago. The patient was advised close follow-up for the left eye, as he was already on tamoxifen therapy (started a month ago) for spinal metastasis. On last follow-up, a year later, the choroidal lesion had completely scarred, with no recurrences. Systemic hormonal therapy like tamoxifen given for the breast primary and other systemic metastases may cause regression of the choroidal metastasis, thereby avoiding ocular radiotherapy. Medline search revealed only one published case of regression of choroidal metastasis from a male breast primary, on tamoxifen therapy.

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“…Responses can be favourable, and complete regression of choroidal metastasis after monotherapy (anastrazole), as well as combined chemotherapy, have been reported (Brinkley 1980;Cohen et al 2005;Manquez et al 2005). Systemic chemotherapy has also been reported to reduce the rate of failure of radiotherapy when administered sequentially (d'Abbadie et al 2003).…”

Section: Responses Of Ocular Metastases To Treatmentmentioning

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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Tamoxifen-Induced Regression of a Choroidal Metastasis in a Man

Cited by 14 publications

References 4 publications

Ocular metastases

Ocular metastases

Systemic chemotherapy and tamoxifen induced regression of choroidal metastasis from a breast carcinoma in a male

Ocular presentations of breast cancer

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