[Breast carcinoma metastasis to the optic nerve: case report and review of literature].

Metastatic tumours of the optic nerve are extremely rare. The review of literature revealed only 12 cases of breast carcinoma metastasis to the optic nerve. All patients survived less then 6 month after surgical treatment. We describe a case of metastatic breast carcinoma to the optic nerve that occurred 8 years after radical mastectomy followed by chemotherapy. The metastasis manifested with progressive decrease in visual acuity in the right eye during 3 month. CT and MRI demostrated enhancing lesion in the muscle cone apex of the right orbit with an extension to the optic canal. The presumable diagnosis was optic nerve sheath meningioma, and surgical resection was performed. The tumour involved the optic nerve and has been resected togeher with the nerve. Histology report confirmed metastatic tumour. Postoperatively, the patient received additional stereotactic radiotherapy. Patient died of tumour dissemination 2,5 years after surgery. Breast carcinoma metastases to the optic nerve usually have unfavorable prognosis both for survival and for visual acuity. Isolated metastatic tumors of the optic nerve remain a diagnostic challenge because of their clinical and radiological similarities to more common primary tumors of the optic nerve.