title: Bilateral multiple extraocular muscle metastasis from breast carcinoma.
abstract: We report a rare presentation of an initially misdiagnosed case of a pseudotumor, which on histopathology was diagnosed as bilateral breast metastases of lobular carcinoma involving multiple extraocular muscles. A 61-year-old lady presented with external ophthalmoplegia and diplopia. Incisional biopsy was performed using a lid crease approach and the patient received radiotherapy and hormonal therapy. Following prolonged hormonal therapy, complete remission was achieved, with improvement in ocular motility and resolution of diplopia, about 18 months after the initial presentation. Multiple extraocular muscle involvement by breast carcinoma metastasis is very rare and should be considered in the differential diagnosis, especially in patients with a prior history of breast carcinoma.
authors.affiliation: Department of Pediatric Ophthalmology and Strabismus and Oculoplasty, Ocular Oncology, and Orbit, L. V. Prasad Eye Institute, L. V. Prasad Marg, Banjara Hills, Hyderabad - 500 073, India. drrameshmurthy@gmail.com
authors.forename: Ramesh
authors.initials: R
authors.lastname: Murthy
authors.forename: Amit
authors.initials: A
authors.lastname: Gupta
authors.forename: Sunayana
authors.initials: S
authors.lastname: Hegde
authors.forename: Santosh G
authors.initials: SG
authors.lastname: Honavar
mesh_terms: D001706:Biopsy; D001943:Breast Neoplasms / Q000473:pathology* / Q000628:therapy; D018275:Carcinoma, Lobular / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D005134:Eye Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D019042:Muscle Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy; D009367:Neoplasm Staging; D009801:Oculomotor Muscles; D013997:Time Factors