Wang Yao, Mettu Pradeep, Maltry Amanda, Harrison Andrew, Mokhtarzadeh Ali
Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, MN, USA.
Ophthalmol Ther. 2017 Dec;6(2):355-359. doi: 10.1007/s40123-017-0093-7. Epub 2017 May 26.
We describe a case of breast cancer metastatic to the superior oblique, in a male. The patient was a 66-year-old Caucasian male with a history of stage IIIB rectal adenocarcinoma and stage IIA left breast carcinoma diagnosed 12 years and 5 years prior, respectively, who presented with headaches and intermittent diplopia. He underwent left total mastectomy with sentinel lymph node biopsy 6 years prior, which showed ER/PR+, HER2/neu-, moderately-differentiated, infiltrating ductal carcinoma with 3/14 positive nodes. He completed adjuvant doxorubicin/cyclophosphamide and oral tamoxifen, and prior routine surveillance imaging had found no evidence of recurrent disease. MRI of the orbit revealed a 0.7 × 1.4 × 1.9 cm mass in the superomedial right orbit in the region of the superior oblique. Transcaruncular orbitotomy with biopsy of the superior oblique revealed metastatic breast carcinoma. Unfortunately, he developed new metastases. Post-operatively, he continues to have good vision with minimal diplopia.
我们描述了一例男性乳腺癌转移至滑车神经的病例。患者为一名66岁的白种男性，分别于12年前和5年前被诊断为IIIB期直肠腺癌和IIA期左乳腺癌，此次因头痛和间歇性复视而就诊。6年前他接受了左侧全乳切除术及前哨淋巴结活检，结果显示为雌激素受体/孕激素受体阳性、人表皮生长因子受体2阴性、中度分化的浸润性导管癌，14个淋巴结中有3个阳性。他完成了辅助性多柔比星/环磷酰胺治疗及口服他莫昔芬治疗，之前的常规监测影像学检查未发现疾病复发的证据。眼眶磁共振成像显示在滑车神经所在的右眼眶内上象限有一个0.7×1.4×1.9厘米的肿块。经泪阜眼眶切开术及滑车神经活检显示为转移性乳腺癌。不幸的是，他出现了新的转移灶。术后，他的视力仍良好，复视轻微。
