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Ptosis and Retinal Lesions as the First Manifestation of Stage 4 Metastatic Breast Cancer: A Case Report

Yael Redler*, Rasha Mosleh, Daniel Briscoe

Introduction: Breast cancer is the most common cancer among women, with prevalence of metastatic disease as high as 30%, despite early diagnosis and aggressive treatment. Breast is the most common site of origin for ocular metastatic tumors. Common presentations of orbital tumors are exophthalmos, pain, decreased vision and diplopia.

Case Description: We present a case of a 57 year old female, with left ptosis that was worsening for 3 months, weakness and fatigue. MRI scan revealed left orbital mass and upon funduscopic examination there were bilateral multiple retinal lesions and hemorrhage. Full workup revealed the patient had stage 4 breast cancers.

Discussion: Ptosis and retinal lesions as the first sign of stage 4 breast cancer was not reported in the literature so far. Ocular metastasis of breast cancer has a high prevalence and a diverse presentation, it is therefore important to consider it in the differential diagnosis of unusual ocular findings.