Breast cancer metastases

4% with breast cancer develop a paraneoplastic syndrome.

see Extradural spinal cord tumor.

Intramedullary spinal metastases.

CSF CEA: levels>1ng/ml are reported with a leptomeningeal spread of lung Ca (89%), breast cancer (60–67%), malignant melanoma (25–33%), and bladder Ca. May be normal even in CEA-secreting cerebral metastases if they don’t communicate with the subarachnoid space. Only carcinomatous meningitis from lung or breast cancer consistently elevates CSF CEA in the majority of patients.

see Breast cancer intracranial metastases.

Metastatic breast cancer in the bone rarely has a cystic appearance, and while it is common in the orbit, its metastasis to the orbito-temporal skull is rare. Consequently, it is difficult to diagnose it. Tao et al. reported a rare case of metastatic breast cancer with simple cyst appearance in the orbito-temporal region of the skull.

A 63-year-old woman presented with mild double vision only on right gaze that lasted for two months. Ten and half years ago, the patient underwent surgery for tumor resection of a stage Ⅲ breast adenocarcinoma, followed by radiotherapy and administration of anticancer therapy. Thereafter, she continued hormonal therapy with anti-estrogen drugs, which was discontinued a half year ago because there was no recurrence during treatment. On admission, magnetic resonance imaging (MRI) showed a single and simple cystic lesion in the orbito-temporal region of the skull. The cyst was filled with fluid of different intensity, indicative of a hemorrhagic component. Additional gadolinium-contrasted MRI showed no enhancing effects in the lesion. The cyst was totally removed by surgery, and the histological examination confirmed the diagnosis of breast adenocarcinoma. Intensity-modulated radiotherapy was then administered, and the patient started follow-up hormonal therapy with anti-estrogen agents. No recurrence in the orbito-temporal region of the skull occurred during six months after the surgery.

Metastatic breast cancer should be considered in the differential diagnosis even if it appears as a simple cyst in the orbito-temporal bone after long-term remission ¹⁾.