ABSTRACT
Isolated metastatic tumors to the optic nerve are extremely rare. We describe a rare
and unusual case of metastatic breast carcinoma to the optic nerve that mimicked an
optic nerve sheath meningioma in its presentation due to its indolent symptom progression,
initial radiological appearance, and minimal growth on serial imaging. The patient,
a 46-year-old woman with a history of stable metastatic breast carcinoma, presented
with progressive visual loss in her right eye over a 6-month interval. Magnetic resonance
imaging revealed an enhancing lesion in the optic canal with an extension to the right
anterior clinoid process and planum sphenoidale and into the right orbital apex, consistent
with the presumptive diagnosis of optic nerve sheath meningioma. The tumor was resected
and pathologically confirmed to be metastatic carcinoma of the breast. The clinical
course, radiological features, surgical approach, and treatment strategies are reviewed.
KEYWORDS
Breast carcinoma - metastatic disease - ocular metastasis - optic nerve tumor - optic
nerve sheath meningioma
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Franco DeMonteM.D.
Department of Neurosurgery, The University of Texas, M.D. Anderson Cancer Center
1515 Holcombe Blvd., Box 0442, Houston, TX 77030
Email: fdemonte@mdanderson.org