Enophthalmos as Initial Manifestation of Occult, Mammogram-Negative Carcinoma of the Breast

A patient with enophthalmos was found to have occult metastatic breast carcinoma to the orbit despite normal findings on breast examination and mammogram. Enophthalmos can be a sign of serious systemic disease and should be appropriately investigated. Despite radiologically interpreted normal orbital and breast imaging, the clinician should rule out underlying subclinical malignancy and consider orbital biopsy.