J Korean Ophthalmol Soc.  2010 Aug;51(8):1161-1165.

A Case of Compressive Optic Neuropathy due to Breast Cancer Metastasis

• Jung JW
• Jin HC
• Kim KS
• Kim YC

Abstract

PURPOSE
To report a case of compressive optic neuropathy due to breast cancer metastasis to the periorbital lesion 26 years after the treatment of primary cancer.
CASE SUMMARY
A 64-year-old female presented with headache, facial pain and visual disturbance in her left eye for four months. The patient had received chemotherapy and radiotherapy after left breast modified radical mastectomy for invasive ductal carcinoma 26 years previously, and right breast wide resection with axillary dissection nine years earlier. Best corrected visual acuity was 20/20 in the right eye and 8/20 in the left eye. The color perception test showed abnormal findings in the left eye. MRI and PET-CT revealed an enhancing mass in the left periorbital area that was compressing the optic nerve. Partial resection of the tumor and left orbital wall was performed. Adjuvant chemotherapy and radiotherapy was performed after the operation. After two months later, the best corrected visual acuity was 20/20 in the left eye, and the color perception test showed normal findings, which have been maintained for one year.
CONCLUSIONS
Prompt management can result in visual recovery in patients with compressive optic neuropathy caused by breast cancer metastasis.

Keyword

Breast cancer; Compressive optic neuropathy

MeSH Terms

Breast
Breast Neoplasms
Carcinoma, Ductal
Chemotherapy, Adjuvant
Color Perception Tests
Eye
Facial Pain
Female
Headache
Humans
Mastectomy, Modified Radical
Middle Aged
Neoplasm Metastasis
Optic Nerve
Optic Nerve Diseases
Orbit
Visual Acuity

Figure

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  Figure 1. Preoperative fundus photographs show no abnormal findings in both eyes.

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  Figure 2. Humphrey visual field test of the left eye. (A) pre-operatively, (B) 2 weeks after periorbital cancer resection, (C) 4 months after operation. Four months after operation, perimetry shows normal findings.

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  Figure 3. Preoperative axial (A) and coronal (B) MR image shows enhancing periorbital mass (arrow) markedly compressing the optic nerve.

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  Figure 4. Radionuclide whole body bone scan reveals abnormal accumulation of radioactivity near left periorbital area (arrow).

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  Figure 5. Postoperative axial (A) and coronal (B) MR image shows decreased degree of optic nerve compression (arrow) by the partial tumor resection.

Reference

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