Lacrimal Gland Metastasis and Paraneoplastic Orbital Myositis due to Breast Carcinoma

We present a case with lacrimal gland metastasis and paraneoplasticorbital myositis due to breast carcinoma. A 66 year-old woman with a history of breast carcinoma was seen with the complaints of headache, blurred vision, and diplopia. 

On neuro-ophthalmologic examination restriction of left, right and up gaze in her left eye was found. Magnetic resonance imaging of orbit revealed enlargement of all extraocular muscles, heterogeneous enhancement of lacrimal gland and retroorbital fat in her left eye. The patient underwent biopsy oflacrimal gland and extraocular muscles. Lacrimal gland metastasis was shown by histopathologic examination, but there was no tumor cells in the extraocular muscles. After radiotherapy for lacrimal gland metastasis, her symptoms relieved remarkably. In patients with a history of malignancy, orbital symptoms and findings should be thought as a cause of malignancy primarily.