Isolated Orbital Metastasis as an Initial Presentation of a Breast Cancer

The patient is a 45-year-old woman with erythema, pain, and palpebral edema in the right eye and binocular diplopia. Computed tomography (CT) of the orbits (Fig. 1A and B) showed a lithic lesion in the right orbital roof with displacement of the superior rectus muscle without infiltration, suggestive of bone metastasis. Results of the fine-needle aspiration study were compatible with breast adenocarcinoma. Breast ultrasound and mammography identified a spiculated nodule in the lower outer quadrant of the right breast, which was confirmed as invasive ductal carcinoma using a core needle biopsy. Bone scintigraphy (Fig. 1C) identified only one focus of increased uptake in the right orbit, with the same findings on PET-CT (Fig. 2).

Fig. 1

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