Extraocular Muscles Involvement as the Initial Presentation in Metastatic Breast Cancer.

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.

Serous borderline tumor of the fallopian tube presented as an adnexal mass.

INTRODUCTION: Serous tumors of low malignant potential (STLMP) of the fallopian tube are uncommon and their clinical behavior is poorly understood. CASE: The authors report a case of a 25-year-old patient that presented an adnexal mass following prolonged pelvic pain. She underwent an exploratory laparotomy and a solid tumor in the left fallopian tube was detected. Left adnexectomy was performed and the pathologic examination revealed a serous borderline tumor of the fallopian tube. Subsequently, the patient underwent a surgical staging procedure that included infracolic omentectomy, and multiple pelvic and abdominal peritoneal biopsies. The pathologic evaluation of all specimens revealed no malignancy. During a follow-up period of 3 years, no evidence of disease was detected. CONCLUSION: Serous borderline tumors of the fallopian tube are diagnosed in the third-fourth decade and are usually discovered incidentally during routine gynecologic examination or during an elective surgery. To date, there are no reports in the literature regarding recurrence or metastatic disease of STLMP of the fallopian tube. Conservative fertility-sparing surgery proved to be a safe and equally effective treatment for patients who wished to preserve their childbearing potential.