ABSTRACT
Orbital metastasis is a rare event, and metastatic disease affecting the extraocular muscles is an even less frequent complication of solid tumors. Herein, we report an unusual case of ptosis as the initial presentation of an invasive breast cancer. A 68-year-old woman presented with III and VI partial nerve paresis, secondary to a compressive retrobulbar mass. Magnetic resonance imaging revealed an infiltrative lesion involving the extraocular muscles. Tissue biopsy yielded a result compatible with metastasis to the orbit, with immunohistochemistry analysis suggesting breast as the primary organ. Mammography identified an area of architectural distortion; stereotactic wire-guided biopsy confirmed the result of the previous orbital biopsy. A positron emission tomography scan demonstrated disseminated disease. Palliative chemotherapy with bone-modulating agents and subsequent hormonal therapy was proposed. Unfortunately, the patient did not respond to therapy and died 38 months after diagnosis.
Subject(s)
Aged , Female , Humans , Biopsy , Breast Neoplasms , Breast , Diagnosis , Drug Therapy , Immunohistochemistry , Magnetic Resonance Imaging , Mammography , Muscles , Neoplasm Metastasis , Oculomotor Muscles , Orbit , Orbital Neoplasms , Paresis , Positron-Emission TomographyABSTRACT
The case of a woman with systemic lupus erythematosus and coexistent milky ascites and meningitis by Listeria monocytogenes is reported. The patient was under longstanding immunosuppressive treatment. Listeriosis is considered an uncommon condition in adults, which occurs as opportunistic infection in immunosuppressed hosts. Samples from ascites showed low triglyceride concentration. Opalescent ascites and Listeria meningitis are rarely reported inpatients with systemic lupus erythematosus.
Relata-se o caso de uma mulher com lúpus eritematoso sistêmico e ascite leitosa coexistente com meningite por Listeria monocytogenes. A paciente estava em tratamento imunossupressivo de longa duração. A listeriose é considerada doença incomum em adultos, que ocorre como infecção oportunista em hospedeiros imunossuprimidos. Amostras da ascite revelaram baixa concentração de triglicérides. Ascite opalecente e meningite por Listeria são raramente descritas em pacientes com lúpus eritematoso sistêmico.