Pseudoinflammatory metastatic breast carcinoma of the orbit and lids

A 60-year-old woman presented five years after a radical mastectomy for breast carcinoma, with vague, non-specific complaints referable to the left eye, consisting of ptosis, extraocular motility problems, and irritation, all believed initially to be due to an inflammatory causation. The indurated quality of the involved tissues, coupled with the results of computed tomographic studies, led to the suspicion of the correct diagnosis, namely, metastatic scirrhous carcinoma of the ocular adnexa. Biopsy and electron microscopic studies confirmed this diagnosis. Clinical and pathologic pitfalls in failing to distinguish scirrhous carcinoma from an inflammatory lesion are discussed.