Title

BILATERAL SEROUS DETACHMENT AS THE FIRST MANIFESTATION OF BREAST CANCER

Introduction

Purpose: to show a case of bilateral choroidal metastasis of breast cancer with decreased vision as the first symptom of the patient

Methods

53-year-old female patient presented with decreased vision in her left eye since 2 days ago. Past ocular, medical and family histories were unremarkable and she was not taking any medications. Her best corrected visual acuity was 20/20 in the right eye and 20/200 in the left eye. Anterior segment examination was revealed normal. Dilated fundus examination revealed in the right eye 2 plaques of yellowish lesion with indistinct borders in temporal arcade and one plaque in nasal arcade.The left eye revealed macular detachment and elevated mass in the macula. OCT displayed small subretinal fluid nasal and extensive serous macular detachment macular on the left eye. Fluorescein angiography show punctate areas of hyper fluorescence over the lesions.. The patient underwent extensive work up including MRI showed osteolytic lesions in the brain, bone and vertebral column.Thoracic CT revealed diffuse pulmonary nodules.Breast biopsy revealed invasive ductal carcinoma. At the moment, the patient has been treated with systemic chemotherapy.

Results

Conclusion: bilateral serous detachment can be he first sign for metastasis, therefore, it is important to perform extensive work up including MRI.Breast cancer is the most common lesion to malignancy to the uvea, accounting for 40% of all uveal metastasis. The classic lesion is yellowish, plateau shaped and associated with sub retinal fluid.

Discussion

Discussion: Breast cancer is also the most common malignancy to metastasize to the uvea. A striking majority of choroidal metastases from breast cancer are yellow in color, plateau shaped,associated with subretinal fluid and located posterior to the equator. Choroidal metastasis from breast cancer was more commonly bilateral (33%) and multifocal (32%) compared with other primary neoplasms.

Keywords

choroidal methastasis

Area

CLINICAL CASE

Authors

PAULO KIN TAKARA, LETICIA SANT'ANA CARDOSO SILVA