P 692Solitary retinal metastasis in breast carcinoma
R. S. Gordes 1,3, U. Jänig2, R. Rochels3
Background: Retinal metastases of breast carcinoma have been rarely described.
Patient: We report on a 49 year-old patient with a 2 year history of adenocarcinoma ot the breast who presented with a temporal retinal detachment and circumscribed fibrotic changes within the retina. A therapeutic and diagnostic pars plana vitrectomy was performed. Acquired vitreous and retinal material was examined cytologically which revealed no malignancy. Preoperative work-up did not show evidence for metastatic disease. After one month a re-detachment of the retina with subretinal fibrotic strands and cellular vitreous infiltration occurred. Another vitrectomy was performed in which re-attachment of the retina could be achieved. Vitreous cytology did not show any malignant cells. During follow-up a "hypopyon" developed with painful bulbar hypotony. There was no light perception. Finally the eye was enucleated. The patient died of her metastatic disease 7 months later .
Histopathologic results: The proliferative changes of the retina were shown to be conglomerates of adenocarcinomacells which stained positive for estrogen and progesterone markers in immunohistochemistry. Conclusions: This case report demonstrates that in spite of invasive diagnostic procedures the presumed correlation between the retinal findings and the breast cancer of this patient could be established. Only with histopathologic examinations of the enucleated globe a rare retinal metastasis was detected.
1University Eye Hospital Lübeck, Ratzeburger Allee 160, D-23538 Lübeck