EC Clinical and Medical Case Reports

While orbital metastases may be the first manifestation of occult breast cancer metastases, they may also be discovered in patients who have already undergone chemotherapy and hormone therapy and may instead represent recurrence of breast cancer. It is reasonable to caution clinicians of new-onset eye symptoms especially in patients with a previous history of breast cancer, metastatic or localized, and that these complaints ought to be worked up fully. This is a case of 58-year-old female, who noticed a small nodular lesion in upper eyelid (orbital area) while on vacation in Italy. The lesion appears to her as a mosquito bite with minimal itching. However, the lesion grew in a few weeks and became irritated. The patient was found to have a one cm hard and non-mobile nodular lesion by physical exam. A biopsy was performed and sent to the pathology department with metastatic lobular carcinoma, breast primary confirmed by immunohistochemistry studies.

Keywords: Metastatic Lobular Carcinoma; Lobular Carcinoma In Situ (LCIS); Breast Cancer; Orbital Metastases

1. Wen HY and Brogi E. “Lobular Carcinoma In Situ”. Surgical Pathology Clinics. W.B. Saunders 11 (2018): 123-145.
2. Pramod N., et al. “Comprehensive Review of Molecular Mechanisms and Clinical Features of Invasive Lobular Cancer”. Oncologist 6 (2021): e943-e953.
3. Wilson N., et al. “Lobular Breast Cancer: A Review”. Frontiers in Oncology 10 (2021).
4. Di Micco R., et al. “Rare sites of breast cancer metastasis: A review. Translational Cancer Research”. AME Publishing Company 8 (2019): S518-S552.
5. Proença RP., et al. “Orbital metastasis from an occult breast carcinoma (T0, N1, M1)”. BMJ Case Reports (2018).
6. Reeves D., et al. “Nonpalpable Breast Carcinoma Presenting as Orbital Infiltration Case Presentation and Literature Review” (2002).
7. Eckardt AM., et al. “Orbital metastases as first sign of metastatic spread in breast cancer: Case report and review of the literature”. Head and Neck Oncology1 (2011).
8. Spraker MB., et al. “Solitary Orbital Metastasis 35 Years after a Diagnosis of Lobular Carcinoma in Situ”. Cureus (2017).
9. Pierson TM., et al. “Orbital Metastases from Breast Cancer: Retrospective Analysis at an Academic Cancer Center”. Breast Journal4 (2016): 447-450.