Metastatic breast carcinoma involving the optic disc.
Am J Ophthalmol Case Rep 2020;
18:100698. [PMID:
32322751 PMCID:
PMC7170934 DOI:
10.1016/j.ajoc.2020.100698]
[Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 03/22/2020] [Accepted: 04/03/2020] [Indexed: 12/04/2022] Open
Abstract
Purpose
To report a rare case of unilateral optic nerve metastasis without choroidal involvement in a patient with known metastatic carcinoma of the breast.
Observations
A 65-year old female with a history of metastatic breast carcinoma presented to our clinic with a one-month history of blurred vision and floaters of the left eye. Fundoscopy of the left eye revealed a flesh colored nodule with white lobules demonstrating an endophytic growth pattern from the optic nerve. Magnetic resonance imaging of the brain and orbits revealed multiple intraparenchymal enhancing lesions, leptomeningeal enhancement, and enhancement of the left optic disc and proximal optic nerve all consistent with metastatic disease. The diffuse cranial disease was treated with whole brain radiation leading to regression of the optic nerve lesion and stabilization of visual acuity.
Conclusions and Importance
Intraocular metastases are the most common malignant tumor of the eye. Prompt identification and treatment of intraocular metastases is vital to prevent severe visual loss. Here, we document an unusual case of optic disc metastasis with unique fundoscopic features.
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