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목적 : Breast cancer mostly metastasizes to the orbit via the haematogenous route and predominantly involves the choroid. Only a limited number of conjunctival breast cancer metastasis has been reported. However, to our knowledge, there is no case of subconjunctival breast cancer metastasis. We present a case of metastatic subconjunctival mass associated with primary breast cancer.
방법 : A 41-year-old woman present with complaints of conjunctival injection and foreign body sensation in the left eye visited our clinic. She was treated with antibiotic and steroid eye solutions at local eye hospital, and was referred to our clinic due to disease progression. She had a history of breast cancer, and was treated two years ago with local excision followed by adjuvant radiotherapy and 10 cycles of chemotherapy.
결과 : On the slit lamp bi-microscopic examination, a cystic mass was noted under the temporal bulbar conjunctiva, associated with dilated overlying conjunctival vessels. An excisional biopsy revealed a poorly differentiated adenocarcinoma, which is positive for CEA, p53, and negative for GCDFP15, TTF-1, oestrogen receptor. An investigation for systemic malignancy with PET revealed multiple systemic metastasis.
결론 : If the metastasis can be detected early, metastatic lesions can be treated successfully with modalities that include external beam radiotherapy or radioactive plaque brachytherapy, and immunotherapies. Metastatic disease should be considered as a differential diagnosis of subconjunctival lesions, and ophthalmic manifestations play an important role in detecting the metastatic spread of a known primary breast cancer.
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