Invasive lobular breast cancer metastatic to the orbit: a case report

Invasive lobular carcinoma represents 5%–15% of breast carcinomas, presenting in many cases as multicentric and bilateral tumors with low mammographic detection. The most common breast cancer metastases are the bones, lungs, brain, and liver. However, the disease can also spread to abdominal cavity, ovaries, and skin. The orbit is an infrequent site of tumor metastasis, ranging from 1% to 13% among all orbital tumors, and breast, lung, and prostate are among the most common primary sites. We report the case of a 73-year-old female patient who presented with a palpable mass in the left orbital rim, whose incisional biopsy revealed a pattern compatible with invasive breast carcinoma with lobular characteristics and E-cadherin overexpression, luminal molecular subtype B. She denied breast complaints and palpable nodules, but on clinical examination she showed a tumor in the inferolateral quadrant of the left breast measuring 6 cm and a left axilla with lymph node enlargement suspected of lymph node involvement. Mammography identified suspicious nodulation in this topography, confirmed by ultrasound. The diagnosis made through core biopsy was an invasive breast carcinoma with lobular characteristics, and the immunohistochemical profile showed luminal molecular subtype B. Systemic staging revealed involvement of the retroperitoneum, left ovarian annex, vertebral bodies, pelvis, right femur, and left iliac suspected for secondary involvement. The patient is currently undergoing adjuvant systemic treatment.