Abstract

Breast cancer is the most common cancer worldwide and, despite its well-known ability to spread to multiple anatomic sites, orbital metastases are considered an exceptional event.

We present the case of a 53-year-old woman who was diagnosed with luminal B cT4cN1M1 breast cancer with lung metastases (M1PUL) and bone metastases (M1OSS) and was treated with palliative chemotherapy, zoledronic acid, and hormonotherapy with no significant benefit (progressive disease).

Two years after the diagnosis, the patient complained of right eye proptosis, local pain and decrease in visual acuity. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a soft tissue mass in the right orbit, extending along the right optic nerve, but not invading it. A multidisciplinary team determined that the best next therapeutic step is orbital palliative radiotherapy. Stereotactic body radiation therapy (SBRT) was used because of the location of the metastasis and the high risk of vision loss. Proptosis and local pain were resolved two months after palliative SBRT and an imaging partial response was obtained.