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乳腺癌眼部及周围组织转移较为罕见。本文报道2例Ⅳ期乳腺癌眼部及周围病灶转移患者的临床症状、影像学表现及治疗情况。2例患者均以视力减退为主要症状。其中1例患者见右侧眼环后上方内可见不规则信号,大小约13.0 mm×3.0 mm×11.4 mm,考虑为乳腺癌眼部转移灶;另1例患者行MRI检查后提示,在右眼眶外侧壁,靠近视神经管处可见一大小约7.1 mm×10.9 mm肿块。2例患者均采取内分泌治疗和全身治疗(包括化疗和靶向治疗)。例1采用TAC方案化疗,发现眼部转移后采用曲妥珠单抗分子靶向治疗,例2采用TAC方案化疗,发现病情进展后采用紫杉类和铂类药物化疗,拒绝靶向治疗。例1给予全脑放疗1个月后患者自觉左眼视力较前好转,至随访截止生存7个月。例2目前右眼失明,至随访截止生存2年8个月。本文提示乳腺癌患者随访期间应行眼部检查。乳腺癌眼部转移早发现、早诊治可以帮助患者恢复视力以及改善生活质量。
Breast cancer and the surrounding tissue around the eye is relatively rare. This article reports the clinical symptoms, imaging findings and treatment of 2 cases of stage IV breast cancer with metastasis of the eye and surrounding lesions. All 2 patients had vision loss as the main symptom. One of the patients could see the irregular signal in the upper part of the right eye ring, the size was about 13.0 mm × 3.0 mm × 11.4 mm, which was considered as eye metastasis in breast cancer. The other patient underwent MRI examination, The outer wall, near the optic canal, a size of about 7.1 mm × 10.9 mm mass. Both patients underwent endocrine therapy and systemic therapy (including chemotherapy and targeted therapy). Example 1 TAC regimen chemotherapy and trastuzumab molecular targeted therapy after eye metastasis was found. Example 2 TAC regimen chemotherapy was used to find that progression of the disease was followed by chemotherapy with taxane and platinum drugs, and targeted therapy was rejected. Example 1 Give whole brain radiation 1 month after the patient conscious visual acuity left eye better than the previous, until the end of the life-saving survival of 7 months. Example 2 Right eye blindness, up to the end of life 2 years and 8 months. This article suggests that breast cancer patients should be checked during eye examination. Early detection of breast cancer eye metastasis, early diagnosis and treatment can help patients restore vision and improve quality of life.