title: Metastatic breast cancer presenting as a subconjunctival mass.
abstract: Breast cancer is the most common primary source of orbital metastasis. Metastasis occurs through hematogenous spread and predominantly involves the choroid. We present a case of a metastatic subconjunctival mass associated with primary breast cancer. To our knowledge, this is the first reported case of its kind. A 41-year-old woman presented with complaints of conjunctival injection and a foreign body sensation in the left eye. She had a history of breast cancer and had been treated 2 years previously with modified radical mastectomy followed by adjuvant radiotherapy and chemotherapy. Slit-lamp examination showed a cystic mass under the temporal bulbar conjunctiva, associated with dilated overlying conjunctival vessels. An excisional biopsy revealed a poorly differentiated adenocarcinoma. Positron emission tomography examination for systemic malignancy revealed multiple systemic metastasis. Metastatic disease should be considered in the differential diagnosis of subconjunctival lesions, and ophthalmic manifestations can play an important role in the detection of metastatic spread of a known primary breast cancer.
authors.affiliation: Department of Ophthalmology, Pusan National University School of Medicine, and Medical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Young Min
authors.initials: YM
authors.lastname: Park
authors.affiliation: Department of Ophthalmology, Pusan National University School of Medicine, and Medical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Jong Ho
authors.initials: JH
authors.lastname: Park
authors.affiliation: Department of Ophthalmology, Institute of Medicine, Kosin University College of Medicine, Busan, Korea.
authors.forename: Seung Uk
authors.initials: SU
authors.lastname: Lee
authors.affiliation: Department of Ophthalmology, Pusan National University School of Medicine, and Medical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Jong Soo
authors.initials: JS
authors.lastname: Lee
keywords: Adenocarcinoma; Breast neoplasms; Conjunctival neoplasms; Subconjunctival neoplasms
references.citation: J Breast Cancer. 2013 Sep;16(3):245-53
references.pmid: 24155753
references.citation: Graefes Arch Clin Exp Ophthalmol. 1992;230(6):527-30
references.pmid: 1427135
references.citation: Cancer Treat Rev. 2005 Jun;31(4):256-73
references.pmid: 15951117
references.citation: Eye (Lond). 2004 Jan;18(1):38-40
references.pmid: 14707963
references.citation: Ophthalmology. 1982 Feb;89(2):147-51
references.pmid: 7070786
references.citation: Cancer. 1976 Sep;38(3):1326-35
references.pmid: 953971
references.citation: Arch Ophthalmol. 1987 Sep;105(9):1215-9
references.pmid: 3307718
references.citation: Breast J. 2004 Jan-Feb;10(1):54-6
references.pmid: 14717761
references.citation: Am J Ophthalmol. 1967 Apr;63(4):723-6
references.pmid: 6022244
references.citation: Am J Ophthalmol. 1979 Jun;87(6):778-82
references.pmid: 572142
references.citation: J R Soc Med. 2003 Jun;96(6):292-4
references.pmid: 12782697
references.citation: Acta Ophthalmol Scand. 2007 Mar;85(2):133-42
references.pmid: 17305726
references.citation: Arch Ophthalmol. 1974 Oct;92(4):276-86
references.pmid: 4412321