Metastatic breast cancer presenting as an epithelial defect.

A 62-year-old woman was referred for evaluation of a nonhealing epithelial defect of the left eye. Examination also revealed left upper lid ptosis, cicatricial lagophthalmos, and palpable lid masses. With probing, the patient admitted to recent history of lobular carcinoma and remote history of ductal carcinoma of the breast. Imaging showed abnormal tissue in the left extraconal orbit involving the lacrimal gland. After orbitotomy and biopsy of the mass, pathology specimens returned consistent with metastatic carcinoma of the left orbit with breast as the site of the primary tumor. The patient completed palliative radiation therapy and chemotherapy. Amniotic membranes were placed to promote healing of the persistent epithelial defect with good response. Unfortunately, the patient died approximately 1 year after her initial presentation secondary to her oligometastatic disease. There is a wide spectrum of clinical manifestations associated with orbital metastasis. Careful consideration must be given to cancer patients with ophthalmologic complaints.

A Rare Pediatric Case of Lacrimal Gland Pleomorphic Adenoma.

Pleomorphic adenoma of the lacrimal gland is a rare benign finding in adults, and extremely uncommon in children. These tumors often present with increased propotosis or hypoglobus, and they invariably require operative excision. While many of these lesions can be removed through a subcranial or transorbital exposure, larger and more posterior tumors occasionally necessitate an intracranial approach. This report describes a large lacrimal gland pleomorphic adenoma in a 16 year-old patient that required use of an expansive intracranial exposure to ensure complete excision including the capsule. We contrast this case and its management to other pediatric cases described in the literature.

Solitary orbital infantile myofibroma: a case report and review of the literature.

Infantile myofibromatosis is a benign condition involving the skin, viscera, or bone that presents rarely in the orbit where rapid growth and bony destruction can mimic malignant tumors. Lesions can be solitary or scattered throughout the body. Growth in viscera such as the lungs can lead to death. Herein, we present a case of a solitary orbital myofibroma in a young child.

Renal medullary carcinoma metastatic to the orbit: a clinicopathologic report.

A 39-year-old black man with sickle cell trait presented with a rapidly progressive, painful proptosis of the left eye. A computed tomographic scan was interpreted as revealing a cavernous hemangioma. Medial orbitotomy revealed a hard, gray mass supranasal to the optic nerve and invading the medial rectus muscle. Intraoperative frozen section specimens were read initially by the pathologist as metastatic adenocarcinoma. On gross examination, the conspicuous hemorrhage, necrosis, and bright yellow color characteristic of renal cell carcinoma were not present. Final pathologic analysis of the orbital lesion revealed metastatic renal medullary cell carcinoma. The primary lesion was located in the right kidney. Renal medullary carcinoma is a rare tumor, often affecting young individuals with sickle cell trait or disease. We report the first confirmed case of renal medullary carcinoma metastatic to the orbit with orbital symptoms preceding the diagnosis of the primary tumor.