Enophthalmos associated with primary breast carcinoma.
OBJECTIVE
The most common source of metastases to the orbit is from breast carcinoma. The orbital presentation can be the presenting sign of the cancer. Proptosis or exophthalmos is the more usual way metastases present, associated with ocular motility problems or diplopia. We present a case of enophthalmos associated with breast carcinoma whereby there is as yet no radiological evidence of an actual orbital metastatic lesion.


METHODS
A 51-year-old Caucasian woman with a known history of breast cancer presented with a 10-month history of vertical diplopia, particularly on upgaze. She noted that her left eye was becoming more "sunken" and examination confirmed an 8-mm enophthalmos on that side with restricted vertical eye movements and abduction.


RESULTS
A provisional diagnosis of metastatic breast cancer was made. CT and MRI scans were performed. The main feature noted was that of orbital fat atrophy with no evidence of an orbital mass. She has been followed up for a period of 2(1/2) years with 6-monthly scans. There has been no progression of her clinical signs and no orbital lesion found so far. We are continuing to review her.


CONCLUSIONS
Although no actual orbital mass has been found yet, we are treating her case as enophthalmos associated with scirrhosing breast carcinoma; she may, however, have spontaneous orbital fat atrophy, triggered by the cancer.
Chang
Bernard Y P
BY
Department of Ophthalmology, Royal Halifax Infirmary, Halifax, England, UK. wendy.lum_hee@virgin.net
Cunniffe
Geraldine
G
Hutchinson
Colin
C
D001943:Breast Neoplasms / Q000150:complications* / Q000473:pathology; D018275:Carcinoma, Lobular / Q000150:complications* / Q000556:secondary; D015841:Enophthalmos / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009918:Orbital Neoplasms / Q000556:secondary