Diplopia and Bone Marrow Failure as Initial Presentation of Breast Cancer: A Case Report

Case Report

Austin Oncol Case Rep. 2023; 6(1): 1018.

Diplopia and Bone Marrow Failure as Initial Presentation of Breast Cancer: A Case Report

Tarek Khrisat; Abdelrahman Habiba; Sydney G McCalla*

Department of General Surgery, Lincoln Medical Center, USA

*Corresponding author: Sydney G McCalla Department of Surgery, Suite 620, Lincoln Medical Center 234 East 149th St., Bronx, NY 10451, USA. Email: tarekkhrisat@gmail.com

Received: March 28, 2023 Accepted: April 27, 2023 Published: May 04, 2023

Abstract

This is a 47-year-old woman who presented to the Emergency room with acute onset of right eye diplopia and drooping of the eyelid associated with fatigue. On further examination, patient noted to have a large fungating right breast mass, reportedly been rapidly growing for the past few months. Also, patient found to have pancytopenia with multiple bony metastases.

This is an interesting case that presents some of the rare metastatic patterns of breast cancer, which can include the orbit, and hematologic abnormalities due to spinal mets. Breast cancer is reported to be responsible for most ophthalmic mets, with it being the primary neoplasms of origin of 40% of the metastases to the orbit.

Keywords: Orbital mets; Pancytopenia; Fungating mass; Breast cancer

Case Report

A 47-year-old woman presented to the Emergency Department with complaints of acute onset right eye diplopia and drooping of the eyelid for the past 3 days. She denied any headache or focal neurological deficits. On further history taking, the patient reported a rapidly growing right breast mass of a few months' duration. Clinical examination revealed hyperemia with exophthalmos and drooping of the right eyelid, bilateral retinal hemorrhages, and an 8x11cm upper outer quadrant fungating right breast mass (Figure 1) with palpable axillary adenopathy. Labs were significant for severe thrombocytopenia with a platelet count of 34x10(3)/mcL.