Bilateral Oestrogen-Receptor-Positive Orbital Metastases as First Presentation of a Receptor-Negative Breast Carcinoma
Link B.1, Conway R. M.1, Kirchner T.2, Holbach L. M.1
1Department of Ophthalmology and Eye Hospital; 2Institute of Pathology, University of Erlangen-Nuremberg, Erlangen
Purpose: To demonstrate a patient with an infiltrative bilateral orbital process as the first presentation of breast carcinoma. The case was unique in that the metastases were oestrogen-receptor (ER)-positive in the presence of a ER-negative primary tumour.
Method: Single interventional case-report presenting clinical, radiologic and immunohistopathologic findings.
Results: A 63-year-old female presented with a 4 months history of bilateral lidswelling and chemosis and intermittent vertical diplopia. A CT-scan of the orbits showed a retro- and peribulbar infiltrative process involving both extraocular muscles and connective tissues. Subsequent orbital and breast biopses confirmed a lobular adenocarcinoma of the breast with bilateral orbital metastases. Hormone receptor studies showed that the primary breast tumour was oestrogen and progesterone receptor negative, whereas the orbital metastases showed strong ER expression.
Conclusions: Infiltrative processes of the orbit radiologically involving both extraocular muscles and connective tissues, are a common presentation of orbital metastatic disease and should prompt early systemic review and/or orbital biopsy. Determination of the hormone receptor st
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