Solitary and bilateral choroidal metastasis revealing breast cancer

Introduction: Breast cancer is complicated by intraocular metastases in 8-10% of cases and these metastases occur most often in patients already known with cancer. Revealing forms are exceptional as well as bilateral involvement. We report an original case characterized by bilateral and solitary (without other visceral or bone secondary locations) choroidal metastasis revealing breastneoplasia. Observation: 38 years old patient with non otable medical history presented to a progressive decrease in visual acuity of the right eye lasting for two weeks and suddenly worsened in the last two days. Ophthalmologic examination showed a larged etachment of the right retina with retinal infiltrates in both sides. The oculo-orbital ultrasound exam showed the presence of bilateral choroidal echogenic, well circumscribed, and homogeneous tissular formations. The exploration was completed by oculo-orbital MRI confirming the same findings. Research of the primitive objectified left breast carcinoma. Reviewing other possible metastases was negative. The patient was assigned to radiotherapy but the evolution was unfavorable with worsening of visual impairment and persistence of choroidal metastases on ultrasound control after one month. Conclusion: An ophthalmologic evaluation with fundus exam may be indicated in the staging of breast neoplasm. In other hand, breast examination should be systematic to the discovery of achoroïdal secondary tumor.