Introduction Breast cancer is the most frequent primary tumor of ocular metastasis in women. The diagnosis must be regarded with uncertainty. Unless there is a histological exam. Otherwise, the diagnosis can be raised on clinical exam and MRI findings.

Methods A retrospective review of five patients diagnosed with orbital metastasis of breast carcinoma from 2017 to 2020 in Salah Azaiz Oncology Institute in Tunisia.

Results All the patients were female and the average age of diagnosis was 59 (range from 51 to 78). All the patients have a history of ductal adenocarcinoma of the breast. The molecular subtype was Luminal A in four cases and was triple negative in one case. The most common signs were proptosis and ptosis. The MRI was performed in four cases and revealed a mass of the extraocular muscle and the retro-orbital space in three cases, an infiltration of extra-orbital muscle in one case. In one case, a contralateral breast carcinoma and pulmonary metastases were found. The other cases were free of metastasis. A navigation-assisted intraorbital biopsy from the orbital roof, performed in one patient, revealed metastasis of breast cancer. All the patients underwent palliative systemic chemotherapy by taxotere. One patient died three months after the diagnosis and four patients are under regular follow-up.

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Abstract 450 Figure 1

Conclusion Orbital metastasis may occur years after the diagnosis. The diagnosis is not evident to establish since the surgical biopsy is not technically possible. The treatment is based on chemotherapy, local radiotherapy, and surgery in some cases.