Department of Ophthalmology and Visual Sciences, Yamagata University Faculty of Medicine, Yamagata, Japan.
Department of Clinical Oncology, Yamagata University Faculty of Medicine, Yamagata, Japan.
Front Endocrinol (Lausanne). 2021 Feb 22;12:625663. doi: 10.3389/fendo.2021.625663. eCollection 2021.
Orbital metastases from cancers of various organs can arise the hematogenous route, and many originate from breast, prostate, and lung cancers. Such metastatic orbital tumors may be diagnosed before the primary tumor. We have encountered a case of breast ductal carcinoma with neuroendocrine differentiation that metastasized to the orbit and responded to chemotherapy, with improvement in visual function.
A woman in her fifties visited our ophthalmology department with a chief complaint of foreign body sensation and exophthalmos in her right eye. An elastic soft mass was palpated from the lateral orbit to the temporal region. A systemic examination revealed breast cancer and a metastatic orbital tumor. Excisional biopsy of the breast revealed a diagnosis of invasive ductal carcinoma with neuroendocrine differentiation, and immunohistochemical examination was negative for cytokeratin 7, making the case unusual. Chemotherapy was remarkably effective, and the tumor size decreased, resulting in improvement of visual function. Her general condition and quality of life are still good at present. We searched the PubMed English language literature focusing on metastatic orbital tumors from breast cancer in which ocular symptoms had been the initial presenting sign. No previous reports have documented neuroendocrine differentiation or cytokeratin 7 expression in isolated orbital metastases from breast cancer. Although it is not possible to be certain from this case alone, we speculated that some such cases might involve cytokeratin 7-negative invasive breast cancer with neuroendocrine differentiation.
We have described our experience of a very rare case of cytokeratin 7 negative breast ductal carcinoma with neuroendocrine differentiation that metastasized to the orbit and formed a solitary giant tumor initially manifesting as ocular symptoms.
来自不同器官的癌症的眼眶转移可通过血行途径发生，许多来源于乳腺癌、前列腺癌和肺癌。这些转移性眼眶肿瘤可能在原发肿瘤之前被诊断出来。我们遇到了一例具有神经内分泌分化的乳腺导管癌转移至眼眶并对化疗有反应，视力功能改善的病例。
一位五十多岁的女性因右眼异物感和突出就诊于我们的眼科部门。从外侧眼眶到颞部可触及弹性软肿块。全身检查发现乳腺癌和转移性眶内肿瘤。乳房的切除活检显示浸润性导管癌伴神经内分泌分化，免疫组织化学检查细胞角蛋白 7 阴性，这使该病例不寻常。化疗效果显著，肿瘤体积缩小，视力功能改善。目前她的一般状况和生活质量仍然良好。我们在 PubMed 英文文献中搜索了以眼部症状为首发表现的乳腺癌转移性眶内肿瘤的病例，未发现先前有关于孤立性眼眶转移来自乳腺癌且具有神经内分泌分化或细胞角蛋白 7 表达的报道。虽然不能仅凭这例病例确定，但我们推测，有些此类病例可能涉及细胞角蛋白 7 阴性的具有神经内分泌分化的浸润性乳腺癌。
我们描述了一例非常罕见的细胞角蛋白 7 阴性乳腺导管癌伴神经内分泌分化转移至眼眶并形成最初表现为眼部症状的孤立性巨大肿瘤的病例。
