Single Orbital Bone Metastasis of Infiltrative Breast Carcinoma in Adults: Interest of a 3-Fields of View Bone SPECT-CT Acquisition

Breast cancer is the largest provider of orbital metastases, which account for 2 to 10% of malignant lesions in the orbit. We report herein the case of a 53-year-old female patient, diabetic for 3 years on oral medication, who initially consulted in the gynecology department for a progressive enlarged right breast nodule, observed on breast self-examination for 1 year. The radio-senological assessment objectified a tissue lesion of the QSE of the left breast class ACR 4C with biopsy returning in favor of an invasive breast carcinoma of no special type (NST). A neoadjuvant chemotherapy has been initiated following a multidisciplinary team meeting. The patient was referred to the nuclear medicine department for a bone scan evaluation after a negative thoraco-abdomino-pelvic CT scan. Whole-body scan revealed a focus of a unique and intense hyperfixation on the skull lateralized on the right. It was therefore proposed a complement by an axial 3 fields of view bone SPECT/CT which objectified a single osteocondensing bone lesion involving the posterior wall of the right orbit very suspect of malignancy. This case demonstrates the interest of a 3 fields of view bone SPECT/CT in the diagnosis of bone metastasis for an optimal management in oncology (Figure 1 and Figure 2).