Proptosis as an Initial Presentation of Metastatic Breast Cancer: A Case Report

Breast cancer accounts for between 28.5% to 58.8% of cases of orbital metastases. Inflammatory lesions, such as orbital pseudotumor, sarcoidosis and granulomatosis with polyangiitis, along with benign tumors and lymphoproliferative disorders form part of the differential diagnosis. We present the case of a 59 year-old woman who presented to her G+P with a one month history of right eye pain, epiphora and proptosis. Initial radiological investigations were indicative of orbital pseudotumor, and thyroid eye disease was ruled out on hematological testing. Second-line radiological imaging increased suspicions of sinister underlying pathology. Consequently, a CT neck-thorax-abdomen-pelvis was indicative of possible underlying mitotic breast disease with lymphangitis and secondary bony and pelvic involvement. The patient was referred for urgent biopsy which confirmed the presence of metastatic breast disease in the orbital cavity. She was subsequently referred for chemotherapy.)

Author(s): Moaz Hamid

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