Orbital metastasis as the first manifestation of luminal B breast cancer in a single functional eye: case report

Breast cancer is the most common oncological diagnosis in Colombian women.Metastatic disease significantly reduces survival, with orbital metastases being rare and often misdiagnosed.A 72-year-old woman with hypertension, Type 2 diabetes, and monocular vision due to an advanced glaucoma in left eye, presented in July 2022 with progressive visual loss, edema, heat, redness, and exophthalmos of her only functional eye.Computed tomography and magnetic resonance imaging revealed an inferior extraconal right orbital mass.Biopsy confirmed metastatic lobular breast carcinoma.Staging showed disseminated bone metastases but no visceral involvement.Initial therapy included ribociclib, letrozole, and zoledronic acid.In January 2024, orbital recurrence prompted localized radiotherapy, resulting in decreased edema, improved proptosis, and partial visual recovery.Systemic therapy continued until April 2025.The patient died shortly thereafter following acute clinical deterioration.Orbital metastasis from breast carcinoma, especially the lobular subtype, is uncommon and may mimic orbital cellulitis.Prompt recognition and histopathological confirmation are essential.