Uncommon Metastasis of Invasive Breast Carcinoma to the Orbit Presenting as Orbital Cellulitis
Recommended Citation
Kareem R, Almukhtar R, Salem N. Uncommon Metastasis of Invasive Breast Carcinoma to the Orbit Presenting as Orbital Cellulitis. Am J Clin Pathol 2025; 164:S13.
Document Type
Conference Proceeding
Publication Date
11-12-2025
Publication Title
Am J Clin Pathol
Keywords
eosin, hematoxylin, progesterone, transcription factor GATA 3, uvomorulin, adult, aged, antibiotic therapy, breast cancer, breast carcinoma, cancer survivor, case report, cell adhesion, clinical article, conference abstract, diagnosis, eyelid biopsy, female, histology, human, human tissue, immunofluorescence, immunohistochemistry, invasive breast cancer, invasive ductal carcinoma, lobular carcinoma, metastasis, middle aged, orbit cellulitis, orbit metastasis, ORBIT score, periorbital edema, radical mastectomy, surgery, tissue section
Abstract
Introduction/Objective: Orbital metastases from breast carcinoma are rare and often present diagnostic challenges due to their clinical resemblance to benign conditions such as orbital cellulitis. Breast cancer is the most common primary tumor to metastasize to the orbit, yet these events remain infrequent and easily misdiagnosed, especially in patients presenting without visual symptoms. Recognizing this presentation is critical in cancer survivors to prevent delays in appropriate treatment. Methods/Case Report: This is a case study of a 69-year-old woman previously diagnosed with estrogen and progesterone receptorpositive, HER2-negative invasive ductal carcinoma of the right breast, treated by radical mastectomy in 2022. She presented in August 2024 with progressive left periorbital swelling and discomfort since April 2024. Despite empirical antibiotic therapy for presumed orbital cellulitis, her symptoms persisted. A full-thickness eyelid biopsy was performed. Tissue sections were stained with hematoxylin and eosin (H&E), followed by immunohistochemistry using CK7, GATA-3, and E-cadherin antibodies. Results: Histologic examination revealed a single-file arrangement of neoplastic cells. Immunostaining was positive for CK7 and GATA-3, with weak E-cadherin expression and loss of intercellular adhesion, confirming metastatic lobular carcinoma of breast origin. Conclusion: This case emphasizes the importance of considering metastatic disease in atypical orbital presentations in breast cancer survivors. Timely biopsy and immunohistochemical analysis are essential for accurate diagnosis and management.
Volume
164
First Page
S13
