Breast cancer metastasis to the conjunctiva

INTRODUCTION

Conjunctival metastasis is exceedingly rare, and it is, as a rule, a sign of advanced malignant disease with poor prognosis. We presented a female patient with breast cancer metastasis to the conjunctiva.

CASE REPORT

A 45-year-old premenopausal female patient was presented with a solitary, yellowish, thin, demarcated lesion in the superior nasal quadrant of the bulbar conjunctiva of the left eye noted by chance a week earlier. There was no sign of irritation, and no pain, and no other functional or morphological problem in either eye or orbit. Five years before the appearance of conjunctival metastasis, breast carcinoma was diagnosed and the patient underwent chemotherapy, preoperative radiotherapy and radical mastectomy. Three years later, computed tomography scan showed metastasis in the left hepatic lobe with ascites and the patient underwent chemotherapy again. But, four months prior to the appearance of conjunctival lesion body scintigraphy showed multifocal sceletal lesions and nuclear magnetic resonance revealed diffuse hepatic metastases and bilateral ovarial tumors. Paliative radiotherapy and hormonal therapy (megestrol, 160 mg) were carried out. An excisional biopsy of the observed conjunctival lesion was performed under topical anesthesia and the material was subjected to histopathological (HP) examination. HP and immunohistochemical examinations established the presence of breast infiltrating lobular carcinoma metastatic to the conjunctiva. The patient showed rapid deterioration after intervention, and died after three weeks.

CONCLUSION

A survival period less than one month after the appearance of conjunctival metastasis deserves attention because it is unexpected and has never been reported previously. It is not a rule that HP presentation of a metastatic lesion is so characteristic that it is possible to determine a primary tumor.

[Dr Jovan Nenadović]

Jovan Nenadović was a famous physician and meritorious citizen of Novi Sad. The occasion to restore the memory of him has arisen sixty years after his death. PROFESSIONAL CARRIER: Jovan Nenadović graduated from Medical Faculty in Graz in 1900. In 1919 he established Dermatovenerology Department at the City Hospital in Novi Sad and Venerology Out-patient Department. He was lifelong honorable president of Dermatovenerology Section of Serbian Medical Society. Nenadović was the first president of the Medical Chamber of Danube Banovina and president of the Society of Physicians of Vojvodina. SOCIAL ACTIVITIES: Nenadović was a vice president of Red Cross Society of Banat, Backa and Baranja. He was well known as patron of the arts, he was a president of the Association of Cultural Societies of Novi Sad and a member of board of Matica Srpska.

[Semi-exenteration of the orbit in therapy of malignant conjunctival tumors]

Authors present their experience in treatment of the conjunctival maliganncies by semiexenteration of the orbit. They discuss the advantages and the disadvantages of this procedure. They suggest the use of semiexenteration in stead of exenteration whenever it is possible.