{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T23:19:30Z","timestamp":1793747970904,"version":"4.6.1"},"reference-count":27,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T00:00:00Z","timestamp":1618790400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>The orbit represents an unusual metastases site for patients diagnosed with cancer, however, breast cancer is the main cause of metastases at this level. These orbital metastases were discovered in patients with a history of breast cancer as unique or synchronous lesions. We present a rare case of a unique retroocular metastasis as the first initial symptom of a tubulo-lobular mammary carcinoma in a postmenopausal woman. A 57-year-old patient complains of diplopia, diminishing visual acuity, orbital tenderness, slight exophthalmia and ptosis of the left eyelid, with insidious onset. Clinical examination and subsequent investigations revealed a left breast cancer cT2 cN1 pM1 stage IV. Breast conserving surgery was performed on the left breast. Pathological examination with immunohistochemistry staining established the complete diagnostic: pT2pN3aM1 Stage IV breast cancer, luminal B subtype. After two years from the initial breast cancer diagnosis, the patient was diagnosed by the psychiatrist with a depressive disorder and was treated accordingly. Orbital metastases are usually discovered in known breast cancer patients and they are found in the context of a multi-system end-stage disease. Most reports cite that up to 25% of the total orbital metastases cases are discovered before the diagnosis of the primary tumor, as our case did. MRI is the gold standard for evaluating orbital tumors. The ILC histological subtype metastasizes in the orbitals more frequently than invasive ductal carcinoma. The prognosis of patients with orbital metastases is poor. The median survival after diagnosis of orbital metastases from a breast cancer primary is ranging from 22 to 31 months. Overall survival of our patient was 56 months, longer than the median survival reported in literature. Orbital metastases must be taken into account when patients accuse ophthalmologic symptoms even in the absence of a personal history of cancer. Objective examination of every patient that incriminates these types of symptoms is essential, and breast palpation must be made in every clinical setting. Orbital biopsy is necessary for the confirmation of the diagnosis and for an adequate treatment. Although recommendations for management of orbital metastases are controversial, it appears that multidisciplinary treatment of both metastases and primary cancer improves overall survival.<\/jats:p>","DOI":"10.3390\/diagnostics11040725","type":"journal-article","created":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T11:21:38Z","timestamp":1618831298000},"page":"725","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Unilateral Orbital Metastasis as the Unique Symptom in the Onset of Breast Cancer in a Postmenopausal Woman: Case Report and Review of the Literature"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5000-5422","authenticated-orcid":false,"given":"Cristina Marinela","family":"Oprean","sequence":"first","affiliation":[{"name":"Morphopathology Department, \u201cVictor Babe\u015f\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. Nr.2, 300041 Timi\u015foara, Romania"},{"name":"Department of Oncology\u2014ONCOHELP Hospital Timisoara, Ciprian Porumbescu Street, No. 59, 300239 Timisoara, Romania"},{"name":"Department of Oncology\u2014ONCOMED Outpatient Unit Timisoara, Ciprian Porumbescu Street, No. 59, 300239 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2948-0365","authenticated-orcid":false,"given":"Larisa Maria","family":"Badau","sequence":"additional","affiliation":[{"name":"Department of Oncology\u2014ONCOHELP Hospital Timisoara, Ciprian Porumbescu Street, No. 59, 300239 Timisoara, Romania"},{"name":"Hygiene Department, \u201cVictor Babe\u015f\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No.2, 300041 Timi\u015foara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nusa Alina","family":"Segarceanu","sequence":"additional","affiliation":[{"name":"Department of Oncology\u2014ONCOHELP Hospital Timisoara, Ciprian Porumbescu Street, No. 59, 300239 Timisoara, Romania"},{"name":"Department of Oncology\u2014ONCOMED Outpatient Unit Timisoara, Ciprian Porumbescu Street, No. 59, 300239 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrei Dorin","family":"Ciocoiu","sequence":"additional","affiliation":[{"name":"Department of Oncology\u2014ONCOHELP Hospital Timisoara, Ciprian Porumbescu Street, No. 59, 300239 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioana Alexandra","family":"Rivis","sequence":"additional","affiliation":[{"name":"Neurosciences Department, \u201cCarol Davila\u201d University of Medicine and Pharmacy of Bucharest, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vlad Norin","family":"Vornicu","sequence":"additional","affiliation":[{"name":"Department of Oncology\u2014ONCOHELP Hospital Timisoara, Ciprian Porumbescu Street, No. 59, 300239 Timisoara, Romania"},{"name":"Neurosurgery Department, \u201cVictor Babe\u015f\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. Nr.2, 300041 Timi\u015foara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7753-7621","authenticated-orcid":false,"given":"Teodora","family":"Hoinoiu","sequence":"additional","affiliation":[{"name":"Department of Clinical Practical Skills, \u201cVictor Babe\u015f\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. Nr.2, 300041 Timi\u015foara, Romania"},{"name":"Clinic of Burns, Plastic and Reconstructive Surgery, \u201cPius Branzeu\u201d Emergency County Hospital, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daciana","family":"Grujic","sequence":"additional","affiliation":[{"name":"Clinic of Burns, Plastic and Reconstructive Surgery, \u201cPius Branzeu\u201d Emergency County Hospital, 300041 Timisoara, Romania"},{"name":"Department of Plastic and Reconstructive Surgery, \u201cVictor Babe\u015f\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. Nr.2, 300041 Timi\u015foara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Bredicean","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, \u201cVictor Babe\u015f\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. Nr.2, 300041 Timi\u015foara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alis","family":"Dema","sequence":"additional","affiliation":[{"name":"Morphopathology Department, \u201cVictor Babe\u015f\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. Nr.2, 300041 Timi\u015foara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,19]]},"reference":[{"key":"ref_1","unstructured":"(2020, July 26). Breast Cancer\u2014Statistics Cancer.Net. 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