Retrobulbäre Metastase als klinische Erstmanifestation eines Mammakarzinoms - ein interdisziplinäres Problem

Zusammenfassung

Während die Metastasierung des Mammakarzinoms in Strukturen des Auges aus gynäkologischer Sicht eine Rarität darstellt, sind Malignome der Brust bei Nachweis von okulären Metastasen der häufigste Primarius. Besonders die Tatsache, dass in 3 % der Fälle die okuläre Metastase als Erstmanifestation eines bis dahin okkulten Mammakarzinoms imponiert [[1]], bedarf einer dahingehenden Sensibilisierung der Fachdisziplinen.

Der vorliegende Fall beschreibt den Krankheitsverlauf einer Patientin mit Erstmanifestation eines bis dahin unbekannten Mammakarzinoms in Form einer retrobulbären Metastase. Bezeichnend ist die lange zeitliche Latenz bis zur endgültigen Diagnose des Mammakarzinoms, die letztlich erst nach bioptischer Sicherung des retrobulbären Tumors histologisch erfolgte.

Abstract

From the gynecologic point of view ocular metastases are uncommon and mostly unknown, while malignancies of the breast are the most common primary tumor when metastases are found in the eye. Even more unknown is the fact that in 3 % of breast cancer cases the first clinical manifestation is a tumor in the eye [[1]]. We describe the case of a 64-year-old woman who has been treated by her ophthalmologists for increasing motility disorders of the eye. The woman had a known endocrinologic orbitopathy. The worsening of her symptoms was at first associated with the endocrinologic orbitopathy. But the initiated corticoid treatment did not improve the symptoms: they even worsened. Subsequently further diagnostic tests were done in the course of which a retrobulbar tumor was diagnosed. The histology suggested the primary tumor was breast cancer. The described procedures took one year, after which the woman was referred to the gynaecological department, where a mammography led to the final diagnosis of breast cancer.

Due to the high incidence of breast cancer the total number of women who first see an ophthalmologist for vision problems caused by a tumor in the eye is not negligible.

This shows that both sides - the gynecologists and ophthalmologists - should be sensitised to the fact that the primary of any tumor of the eye can be breast cancer, in order to direct treatment more quickly to the cause of the cancer, thus leading to a better curative success.

Schlüsselwörter

Retrobulbäre Metastase - choroidale Metastase - Mammakarzinom - okkultes Mammakarzinom

Key words

Breast cancer - retrobulbar metastasis - ocular metastasis

Literatur

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