Abstract
Introduction: The incidence of ocular metastasis from Breast Carcinoma is only between 5% - 30%, mainly located in choroid, but the location in optic nerve is even more infrequent. We present a rare case that combined both locations sequentially in the same eye. Methods: Case report. Results: A 58-year-old woman with advanced breast cancer was referred with a choroidal metastasis in her right eye which responded well to systemic Taxol and Avastin. Afterwards, she developed an optic nerve metastasis in the same eye when she was under the treatment, so it was changed to Docetaxel. Unfortunately the patient didn’t respond to this treatment and died. Conclusions: Choroidal metastasis secondary to breast cancer generally responds well to radiotherapy. Even so, in cases that a great deterioration of visual acuity is expected after radiation, chemotherapy like taxanes is an alternative to preserve vision with complete tumor regression. Nevertheless, the presentation of a second metastasis in optic nerve can be indicative of inadequate treatment of metastatic disease or complication of the treatment, or both.
Highlights
The incidence of ocular metastasis from Breast Carcinoma is only between 5% - 30%, mainly located in choroid, but the location in optic nerve is even more infrequent
The incidence of ocular metastasis from breast cancer ranges between 5% - 30% [1] [2], with a 37% of microscopic uveal affectation [2], whereas only 4.5% of all intraocular metastasis develop in the optic nerve, 43% of them coming from a primary breast neoplasia [3]
The most supported treatment for ocular metastasis consists of treating the metastatic basal disease, specially if they are unresectables, the prognosis of life is limited and radiotherapy can threaten the vision as in case of posterior locations or the optic nerve. 25% - 40% of patients with breast cancer develop metastasis distantly in spite of treatment, which is considered to be incurable, but the palliative existing therapies obtain free-disease intervals that are in occasions very long
Summary
Breast carcinoma is the most frequent tumor in women and the second reason of death in them. How to cite this paper: Asencio-Duran, M., et al (2014) Optic Nerve Metastasis from Breast Carcinoma after Treatment with Taxanes. Case Reports in Clinical Medicine, 3, 336-339. M. Asencio-Duran et al There are several treatment options for these metastasis, including observation, systemic treatment (cytotoxic, hormonal and inmunomodulatory agents), radiotherapy (external beam radiotherapy = EBRT, or by means of plaques), local resection, photocoagulation, transpupillary termotherapy, cryotherapy or enucleation [1]. We present a rare case that combined both choroidal and optic nerve location sequentially in the same eye and that responded differently to treatment
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