Orbital metastasis as the presenting sign of adenocarcinoma of the breast.

A 64-year-old woman presented with periorbital induration of 6 months' duration. Computed tomography (CT) revealed enlargement of extraocular muscles. A biopsy specimen of the orbicularis muscle and indurated preaponeurotic fat demonstrated an infiltrating carcinoma, and immunoperoxidase studies for surface antigens suggested a metastatic adenocarcinoma. Extensive evaluation revealed a 1-cm subareolar breast mass, with histopathological features identical to those of the orbital lesion. Orbital metastasis presenting before the diagnosis of a primary breast cancer is unusual, particularly in the absence of other disseminated disease.