Orbital metastasis is a rare event, and metastatic disease affecting the extraocular muscles is an even less frequent complication of solid tumors. Herein, we report an unusual case of ptosis as the initial presentation of an invasive breast cancer. A 68-year-old woman presented with III and VI partial nerve paresis, secondary to a compressive retrobulbar mass. Magnetic resonance imaging revealed an infiltrative lesion involving the extraocular muscles. Tissue biopsy yielded a result compatible with metastasis to the orbit, with immunohistochemistry analysis suggesting breast as the primary organ. Mammography identified an area of architectural distortion; stereotactic wire-guided biopsy confirmed the result of the previous orbital biopsy. A positron emission tomography scan demonstrated disseminated disease. Palliative chemotherapy with bone-modulating agents and subsequent hormonal therapy was proposed. Unfortunately, the patient did not respond to therapy and died 38 months after diagnosis.
Aged ; Biopsy ; Breast Neoplasms* ; Breast* ; Diagnosis ; Drug Therapy ; Female ; Humans ; Immunohistochemistry ; Magnetic Resonance Imaging ; Mammography ; Muscles* ; Neoplasm Metastasis ; Oculomotor Muscles ; Orbit ; Orbital Neoplasms ; Paresis ; Positron-Emission Tomography

Ultrasonography is highly accurate for evaluating soft tissues. Given that minimally invasive aesthetic procedures are on the rise, complications have become more prevalent. Thus, ultrasonography holds promise for assisting in the diagnosis and management of complications arising from these interventions. This report highlights the importance of ultrasonography in the treatment of complications caused by hyaluronic acid injection. A patient visited a dentaloffice 24 hours after hyaluronic acid application, presenting pain and bruising in the middle and inferior thirds of theface on the right side. To evaluate blood vessels, the surgeon used Doppler-mode ultrasonography, which enabled the precise application of hyaluronidase to reestablish blood perfusion and preserve adjacent structures. Therefore, to avoid severe outcomes, such as necrosis or even amaurosis, the use of ultrasonography is suggested, improving the precision and safety of these procedures.

Ultrasonography is highly accurate for evaluating soft tissues. Given that minimally invasive aesthetic procedures are on the rise, complications have become more prevalent. Thus, ultrasonography holds promise for assisting in the diagnosis and management of complications arising from these interventions. This report highlights the importance of ultrasonography in the treatment of complications caused by hyaluronic acid injection. A patient visited a dentaloffice 24 hours after hyaluronic acid application, presenting pain and bruising in the middle and inferior thirds of theface on the right side. To evaluate blood vessels, the surgeon used Doppler-mode ultrasonography, which enabled the precise application of hyaluronidase to reestablish blood perfusion and preserve adjacent structures. Therefore, to avoid severe outcomes, such as necrosis or even amaurosis, the use of ultrasonography is suggested, improving the precision and safety of these procedures.

Ultrasonography is highly accurate for evaluating soft tissues. Given that minimally invasive aesthetic procedures are on the rise, complications have become more prevalent. Thus, ultrasonography holds promise for assisting in the diagnosis and management of complications arising from these interventions. This report highlights the importance of ultrasonography in the treatment of complications caused by hyaluronic acid injection. A patient visited a dentaloffice 24 hours after hyaluronic acid application, presenting pain and bruising in the middle and inferior thirds of theface on the right side. To evaluate blood vessels, the surgeon used Doppler-mode ultrasonography, which enabled the precise application of hyaluronidase to reestablish blood perfusion and preserve adjacent structures. Therefore, to avoid severe outcomes, such as necrosis or even amaurosis, the use of ultrasonography is suggested, improving the precision and safety of these procedures.

Ultrasonography is highly accurate for evaluating soft tissues. Given that minimally invasive aesthetic procedures are on the rise, complications have become more prevalent. Thus, ultrasonography holds promise for assisting in the diagnosis and management of complications arising from these interventions. This report highlights the importance of ultrasonography in the treatment of complications caused by hyaluronic acid injection. A patient visited a dentaloffice 24 hours after hyaluronic acid application, presenting pain and bruising in the middle and inferior thirds of theface on the right side. To evaluate blood vessels, the surgeon used Doppler-mode ultrasonography, which enabled the precise application of hyaluronidase to reestablish blood perfusion and preserve adjacent structures. Therefore, to avoid severe outcomes, such as necrosis or even amaurosis, the use of ultrasonography is suggested, improving the precision and safety of these procedures.