Zusammenfassung
Während die Metastasierung des Mammakarzinoms in Strukturen des Auges aus gynäkologischer
Sicht eine Rarität darstellt, sind Malignome der Brust bei Nachweis von okulären Metastasen
der häufigste Primarius. Besonders die Tatsache, dass in 3 % der Fälle die okuläre
Metastase als Erstmanifestation eines bis dahin okkulten Mammakarzinoms imponiert
[[1]], bedarf einer dahingehenden Sensibilisierung der Fachdisziplinen.
Der vorliegende Fall beschreibt den Krankheitsverlauf einer Patientin mit Erstmanifestation
eines bis dahin unbekannten Mammakarzinoms in Form einer retrobulbären Metastase.
Bezeichnend ist die lange zeitliche Latenz bis zur endgültigen Diagnose des Mammakarzinoms,
die letztlich erst nach bioptischer Sicherung des retrobulbären Tumors histologisch
erfolgte.
Abstract
From the gynecologic point of view ocular metastases are uncommon and mostly unknown,
while malignancies of the breast are the most common primary tumor when metastases
are found in the eye. Even more unknown is the fact that in 3 % of breast cancer cases
the first clinical manifestation is a tumor in the eye [[1]]. We describe the case of a 64-year-old woman who has been treated by her ophthalmologists
for increasing motility disorders of the eye. The woman had a known endocrinologic
orbitopathy. The worsening of her symptoms was at first associated with the endocrinologic
orbitopathy. But the initiated corticoid treatment did not improve the symptoms: they
even worsened. Subsequently further diagnostic tests were done in the course of which
a retrobulbar tumor was diagnosed. The histology suggested the primary tumor was breast
cancer. The described procedures took one year, after which the woman was referred
to the gynaecological department, where a mammography led to the final diagnosis of
breast cancer.
Due to the high incidence of breast cancer the total number of women who first see
an ophthalmologist for vision problems caused by a tumor in the eye is not negligible.
This shows that both sides - the gynecologists and ophthalmologists - should be sensitised
to the fact that the primary of any tumor of the eye can be breast cancer, in order
to direct treatment more quickly to the cause of the cancer, thus leading to a better
curative success.
Schlüsselwörter
Retrobulbäre Metastase - choroidale Metastase - Mammakarzinom - okkultes Mammakarzinom
Key words
Breast cancer - retrobulbar metastasis - ocular metastasis
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Dr. med. Barmak Adhami
Frauenklinik für Gynäkologie und Geburtshilfe der Universitätsklinik Aachen
Pauwelsstraße 30
52074 Aachen
Email: badhami@ukaachen.de
