118P - Metastasic Breast Carcinoma to the Gallbladder and the Lower Eyelid with No Malignant Lesion in the Breast: An Unusual Case Report with a Short Review of Literature

Abstract

Background: Breast carcinoma has the potential for widespread dissemination, such as metastasis to axillary lymph nodes, bone, lung, pleural, brain, and soft tissues. Liver, gastrointestinal, and biliary tract involvement are infrequent; In fact, Gallbladder metastases are very rare and usually arise from malignant melanoma, renal cell carcinoma and cervical cancer. Metastatic eyelid tumours are rare and account for less than 2% of all eyelid neoplasms carcinoma;Case presentation: 51 year old woman who carries a bilateral silicone breast prosthesis, presented with an unsightly subcutaneous nodule in the left lower eyelid justifying its removal, while the orbital scanner has objectified the appearance of an angiomatous arteriovenous malformation; Histological study of the resected specimen objective histological appearance of metastatic breast cancer to the lower eyelid of a lobular breast carcinoma hormone receptor positive, while the patient was free of symptoms; the imaging tests (mammography, Bilateral breast MRI), biochemical tests, blood cell count and tumor markers MRI repeated several times, were also normal without malignant lesion in the breast. At the 9th month after surgery however, the patient developed symptoms of cholecystitis and underwent cholecystectomy. The histopathological examination revealed metastasis of the lobular carcinoma and the subsequent immunohistochemical examination showed the lesion to becytokeratin 7 and 20-negative and mammoglobine GCDFP-15-positive which confirmed the breast origin. Estrogen receptor and progesterone receptor were positive, but there was no overexpression of the Neu oncogene or consequent increase of tumor markers. Hormonal treatment was initiated with tamoxifen and LH-RH antagonists and at 8 months of treatment, with progressive and significant decrease of tumor markers, there was still no primary tumor.Conclusion: Symptoms of cholecystitis should not be neglected in such patients, as they might indicate metastasis to the gallbladder. Cutaneous metastases to the eyelid are rare however should be in the differential diagnosis of patients with solitary nodules, ulceration, and skin changes involving the eyelid.Disclosure: All authors have declared no conflicts of interest. Background: Breast carcinoma has the potential for widespread dissemination, such as metastasis to axillary lymph nodes, bone, lung, pleural, brain, and soft tissues. Liver, gastrointestinal, and biliary tract involvement are infrequent; In fact, Gallbladder metastases are very rare and usually arise from malignant melanoma, renal cell carcinoma and cervical cancer. Metastatic eyelid tumours are rare and account for less than 2% of all eyelid neoplasms carcinoma; Case presentation: 51 year old woman who carries a bilateral silicone breast prosthesis, presented with an unsightly subcutaneous nodule in the left lower eyelid justifying its removal, while the orbital scanner has objectified the appearance of an angiomatous arteriovenous malformation; Histological study of the resected specimen objective histological appearance of metastatic breast cancer to the lower eyelid of a lobular breast carcinoma hormone receptor positive, while the patient was free of symptoms; the imaging tests (mammography, Bilateral breast MRI), biochemical tests, blood cell count and tumor markers MRI repeated several times, were also normal without malignant lesion in the breast. At the 9th month after surgery however, the patient developed symptoms of cholecystitis and underwent cholecystectomy. The histopathological examination revealed metastasis of the lobular carcinoma and the subsequent immunohistochemical examination showed the lesion to becytokeratin 7 and 20-negative and mammoglobine GCDFP-15-positive which confirmed the breast origin. Estrogen receptor and progesterone receptor were positive, but there was no overexpression of the Neu oncogene or consequent increase of tumor markers. Hormonal treatment was initiated with tamoxifen and LH-RH antagonists and at 8 months of treatment, with progressive and significant decrease of tumor markers, there was still no primary tumor. Conclusion: Symptoms of cholecystitis should not be neglected in such patients, as they might indicate metastasis to the gallbladder. Cutaneous metastases to the eyelid are rare however should be in the differential diagnosis of patients with solitary nodules, ulceration, and skin changes involving the eyelid. Disclosure: All authors have declared no conflicts of interest.