Metastatic Breast Carcinoma Masquerading as Eyelid Swelling: A Case Report

Abstract

Eye metastases are rare, with breast carcinoma being the most prevalent primary tumour among all metastatic tumours to the eye. Eyelid metastases have been very rarely reported. This case report details the presentation of a 51-year-old Malay woman with underlying Diabetes Mellitus, who presented with persistent left lower eyelid swelling for two months, initially resembling a small pimple, progressively increased in size, accompanied by erythema. Previous consultations with a private ophthalmologist were treated as preseptal cellulitis. Notably, the patient had a one-year history of progressive swelling of the right breast, however, didn't seek medical attention previously. Examination of the left eye revealed a lower lid mass, moderate to firm in nature, erythematous nasally. Systemic examination revealed a right breast lump, firm to hard consistency, adhered to the underlying chest wall and overlying skin, peau d’ orange skin changes, with nipple retracted.  CECT orbit demonstrated features suggestive of eyelid malignancy. An incisional biopsy was done, and HPE results revealed metastatic carcinoma, likely of breast origin, subsequently planned for chemotherapy. Patients presenting with eyelid swelling should be evaluated for possible metastases, a detailed systemic examination is necessary for establishing the diagnosis. Initiating early treatment enhances patient outcomes and quality of life.