Metástases Orbitárias Bilaterais em Cancro da Mama: Revisão da Literatura Sobre um Caso Clínico Raro
DOI:
https://doi.org/10.48560/rspo.33077Palavras-chave:
Breast Neoplasms, Orbital Neoplasms/secondaryResumo
As metástases bilaterais da órbita no cancro da mama são uma condição rara, podendo se apresentar como a manifestação inicial de um tumor primário não detectado. O cancro da mama hormono-positivo (HR +) / HER2-negativo (HER2-), particularmente o subtipo lobular, é a origem primária mais comum. Apesar do progresso no tratamento do cancro da mama, estratégias eficazes na abordagem das metástases da órbita continuam a ser um desafio pela sua associação com doença avançada. Relatamos o primeiro caso clínico de metástases bilaterais da órbita como manifestação inicial de cancro da mama bilateral, eficazmente tratado com uma combinação de um inibidor de CDK4/6 e um inibidor de aromatase. Revimos e analisamos características clínicas, subtipos histológicos, estratégias de tratamento e resultados associados a metástases bilaterais da órbita de cancro da mama. O caso envolve uma mulher de 53 anos com aumento da pressão intraocular e edema do disco ótico direito no tomografia de coerência ótica (OCT). A marcha diagnóstica culminou em carcinoma lobular metastizado da mama HR+/HER2-, tendo apresentado uma resposta marcada ao abemaciclib e ao letrozol. Uma revisão de 48 doentes revelou uma população predominantemente feminina (96%) com idade média de 59 anos. Do total dos casos, 37% não apresentavam história prévia de cancro e 65% apresentavam metástases distantes concomitantes. Limitação da motilidade ocular (58%) e perda de visão (33%) são os sinais mais comuns. Imagiologicamente, frequentemente ocorre infiltração das partes moles (71%), com 44% envolvendo músculos extraoculares. Histologicamente, a maioria dos casos apresenta características lobulares (71%). A sobrevida média global nesta coorte foi de 12 meses (variando de 0,5 a 41 meses). Em conclusão, as metástases bilaterais da órbita em cancro da mama são uma condição desafiadora. Este estudo destaca as características clínicas e resultados de tratamento, ressaltando a necessidade de abordagens terapêuticas inovadoras para melhorar o prognóstico geralmente reservado.Downloads
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