Orbital tumour as a presenting symptom of breast carcinoma: Value of detecting hormone receptors

A 54-year-old woman was referred for evaluation of an orbital tumour after 5 months of non-specific ophthalmic symptoms. Tissue obtained by an open orbital biopsy was highly suspicious for asymptomatic metastatic breast carcinoma, which was discovered a few weeks later. Unlike the primary tumour, which was an invasive lobular breast carcinoma, the metastatic tissue was repeatedly negative for oestrogen and progesterone receptor markers. A possible reason is a change in cellular cytoplasmic and nuclear protein composition during the metastatic process, Since the primary tumour was positive for the hormone receptors, the patient was treated by chemotherapy and tamoxifen. The follow-up supports a favourable effect of adjuvant endocrinological therapy even in cases with receptor-negative metastatic tissue, This report is in partial contradiction to some previously published cases and emphasises the role of receptor status in the primary tumour.