The natural history of untreated breast carcinoma metastatic to the eyelids: A case report

Digby W Allen,^1,2 William Boneham,¹ Brent Skippen,^1,2 

1. Wagga Wagga Base Hospital, Wagga Wagga, NSW,  Australia
2. Wagga Wagga Rural Clinical School, School of Medicine, The University of New South Wales, Wagga Wagga, NSW,  Australia

Abstract

Metastases to the eyelids are rare and most frequently originate from lobular breast carcinomas. This case represents the first description of breast cancer metastatic to the eyelids treated with only high dose intravenous vitamin C therapy and no medical or surgical treatment, therefore adding to the foundation of information pertaining to metastatic periocular disease. Recognition of isolated bilateral eyelid lesions as a sentinel presentation for metastatic disease is an important consideration to avoid misdiagnosis. Increasing awareness of the natural history of breast cancer metastatic to the eyelids may better inform patients who may elect not to proceed with oncological treatment. The natural history of metastatic lobular breast cancer in this patient treated with high dose Vitamin C demonstrated progressive spread to all four eyelids and death from systemic complications eight months after initial presentation. Ultimately this will assist clinicians communicating the potential prognosis associated with no oncological treatment and empower patients to make informed decisions regarding their care goals.