Uncommon orbital metastasis in ductal breast carcinoma: a rare presentation 12 years after treatment.

Orbital metastasis originating from breast carcinoma, particularly ductal carcinoma, represents a rare clinical entity, with lobular carcinoma usually being more common. Long-term surveillance in breast cancer patients is crucial for early detection of metastasis. Herein, we present a case of a 70-year-old woman with a history of left ductal breast carcinoma, diagnosed and treated 12 years ago. She then developed left eye vision loss, diplopia, enophthalmos, and chemosis in October 2024. Imaging revealed orbital metastasis involving the left superior and lateral rectus extraocular muscles. Biopsy confirmed the diagnosis of orbital metastases arising from ductal breast carcinoma. This case underscores the significance of long-term surveillance in breast cancer patients, as metastasis can manifest years after the initial diagnosis. Despite its rarity, orbital metastasis warrants consideration in the differential diagnosis of ocular symptoms in patients with a history of breast carcinoma. Treatment primarily aims at palliation and preserving visual function, with prognosis typically poor.

Primary malignant melanoma of the parotid gland: A case report.

The primary malignant melanoma of the parotid is a rare and complex clinical entity, posing numerous diagnostic challenges due to the absence of melanin in the tumor and its histological similarities with other poorly differentiated lesions. Accurate diagnosis often requires advanced imaging techniques and immunohistochemical procedures to identify specific melanoma markers. Therapeutically, total parotidectomy with simultaneous cervical dissection is frequently recommended, although approaches combining surgery, chemotherapy, radiotherapy, or even immunotherapy are also being explored. Despite these advancements, malignant parotid melanoma continues to be associated with a grim prognosis, emphasizing the importance of ongoing research to improve therapeutic options and understanding of this rare pathology.

Bilateral swelling of the lacrimal glands as first manifestation of systemic sarcoidosis in a patient with breast cancer.

Sarcoidosis, a multifaceted granulomatous disease primarily affecting the lungs, occasionally presents in atypical locations. Lacrimal gland involvement, though rare, poses distinct diagnostic challenges. This case report details a 52-year-old female with bilateral lacrimal gland swelling initially suggestive of metastatic tumor due to a history of breast cancer. Subsequent investigations, including CT and MRI, unveiled pulmonary sarcoidosis. Discussion emphasizes the diverse ocular manifestations of sarcoidosis, with lacrimal gland participation potentially indicating early stages. Diagnostic complexities involve differentiation from other lacrimal pathologies, including neoplasms, lymphoproliferative disorders, Sjögren's syndrome, Wegener's granulomatosis, tuberculosis, and IgG4-related disease. In summary, while lacrimal gland involvement in sarcoidosis is infrequent, it should be considered in orbital masses, necessitating a comprehensive approach for accurate diagnostic orientation in such cases.

Diffuse malignant peritoneal mesothelioma mimicking ovarian cancer.

Diffuse malignant peritoneal mesothelioma (DMPM) and peritoneal carcinomatosis have similar computed tomography imaging features. Peritoneal carcinomatosis is a known metastatic site for many malignancies and particularly gastrointestinal tract and ovarian cancers. Also, DMPM can masquerade as an ovarian epithelial neoplasm, with very similar clinical presentation and an overlap in imaging findings. When no evident primary tumor is detected other than the peritoneal disease, primary malignant mesothelioma should be considered. Since accurate diagnosis is essential for treatment management, the gold standard in differentiating between these two entities lies in histological analysis. We report a case of DMPM that was initially misdiagnosed as an ovarian cancer, where the biopsy of a peritoneal nodule was able to correct and confirm the diagnosis of DMPM.

Left circumflex artery fistula to left atrium: a rare case report.

Coronary artery fistulas are rare congenital anomalies of coronary termination. There are 3 types: (1) cameral coronary fistulas, (2) pulmonary coronary fistulas, and (3) bronchial coronary fistulas. Left circumflex coronary artery to left atrial fistula are exceptional. Imaging, especially the CT angiogram, must establish an anatomical classification of the fistula for therapeutic purposes, by specifying its origin, its path, its size and its termination. We report a rare case of the left circumflex coronary artery to left atrial fistula in a 31 year old man, which is an uncommon presentation of coronary termination anomalies. The CT coronary angiogram must describe the origin segment of the fistula and the drainage site which have therapeutic consequences.