Pinto Proença, RFernandes, JBurnier, MProença, R2023-03-012023-03-012018-04BMJ Case Rep . 2018 Apr 11;2018:bcr2017223542.http://hdl.handle.net/10400.17/4429The authors report a case of an orbital metastasis from an occult breast carcinoma. A 66-year-old woman presented with a growing left orbital tumour. Orbital CT scan was consistent with lymphoma. However, ocular pathology revealed small neoplastic cells showing an 'indian file pattern' suggestive of metastatic carcinoma and immunohistochemistry was positive for CK7, CK CAM5.2 and oestrogen receptor. A systemic evaluation was then performed with mammogram, breast ultrasound and MRI considered normal. An exhaustive systemic evaluation revealed multiple bone lesions, a right axillary lymph node lesion, which presented the same pattern on pathology and immunohistochemistry, with no evidence of a primary tumour. A diagnosis of a metastatic lobular carcinoma of the breast (T0, N1, M1) was made and the patient was started on chemotherapy and adjuvant hormonal therapy.engCHLC OFTAgedFemaleHumansBiomarkers, TumorBiopsyBreast Neoplasms / diagnostic imagingBreast Neoplasms / pathology*Carcinoma, Lobular / diagnostic imagingCarcinoma, Lobular / secondary*Combined Modality TherapyEye Neoplasms / diagnostic imagingEye Neoplasms / pathologyEye Neoplasms / secondary*Eye Neoplasms / therapyKeratin-7 / analysisMagnetic Resonance ImagingMammographyNeoplasms, Unknown Primary / diagnostic imagingNeoplasms, Unknown Primary / pathology*Neoplasms, Unknown Primary / therapyTomography, X-Ray ComputedUltrasonographyWhole Body Imagingjournal article10.1136/bcr-2017-223542