|Year : 1974 | Volume
| Issue : 3 | Page : 20-21
Intraocular metastasis in primary breast cancer
L. L. R. M. Medical College, Meerut, India
I N Raizada
L. L. R. M. Medical College, Meerut
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Raizada I N. Intraocular metastasis in primary breast cancer. Indian J Ophthalmol 1974;22:20-1
Secondary choroidal deposits from primary tumours in other parts of the body are rare. A case of choroidal metastasis from a breast carcinoma is being presented due to its rarity.
| Case Report|| |
K.W. a woman of 48 years, in menopause, using presbyopic glasses attended the department of ophthalmology, L. L. R. M. Medical College, Meerut, with complaints of failing vision and dull pain in the right eye.
Ocular Examination : Vision the in right eye was counting fingers at one meter and left eye had vision of 6)9. Funduscopy showed a large, slightly raised yellowish grey area in the upper temporal quadrant in the right eye involving the macula. [Figure - 1] Intraocular tension and anterior segments in both eyes were normal.
General Examination : A small tumour was found in the upper inner quadrant of the right breast. Regional lymph nodes were enlarged. The patient was referred to the surgical side. A biopsy was done. Histologically, the tumour was poorly differentiated invasive carcinoma. [Figure - 2]
She had no neurological signs. She died after 7 months.
| Discussion|| |
Retinal secondaries as a manifestation of generalised disease are rare. Pearls' for the :first time in 1872 reported secondaries in the eye from primary bronchogenic carcinoma.
Godtfredsen  reported an incidence of 0.7%. Albert  et al reported the incidence of metastsis in the eye or the orbit as 0.7%. Guthert  et al on autopsy examination of the eyes of proven systemic carcinoma, reported an incidence of 0.5%. Bloch and Gartner  found intraocular lesion in 12% of patients. In Moorefield Eye Hospital, from 1935 to 1953, 40 cases of metastatic carcinoma of the choroid were noted.
The incidence of secondaries in the eye in cases of generalised disease is low because of the anatomical relationship of the ophthalmic artery to the internal carotid artery. The ophthalmic artery arises at right angle from the artery and the metastatic emboli tend to pass straight to the brain and the meninges instead of going into the eye. The left eye is mostly affected because the tumour emboli pass into the left common carotid artery directly from aorta.
| Conclusion|| |
A case of retinal metastasis from primary breast cancer has been reported.
The interesting features of the case are (a) Initial visual presentation. (b) Involvement of the right eye. (c) No neurological symptoms.
| References|| |
Albert D. Rubenosteen, R. and Scheie, H., 1967 Amer. J. Ophthal. 63,
Bloch, R.S. and Gartner, S., 1971 Arch Ophthal.
Duke-Elder, Perkins, E.S., 1966 System of Ophthalmology 9,
917 London Kimpton.
Godtfredsen, E., 1944 Acta Ophthal 22,
Gudhert, H., Janish, W. and Rossbach. K, 1965 Munch med schr 107, 939. cited by Bolus Journal of R.C.S., Edinburgh 18,
Pearls, M. (1972 Vircows Arch Path Anat. Physiol 56, 445.
Quoted by Duke Elder, Vol. IX.
[Figure - 1], [Figure - 2]