J Korean Ophthalmol Soc.  2017 Jan;58(1):106-112. 10.3341/jkos.2017.58.1.106.

A Case of Choroidal Metastasis Caused by Lung Cancer

• Oh JH
• Ko SJ
• Yang YS
• Choi CW

• KMID: 2367851
• DOI: http://doi.org/10.3341/jkos.2017.58.1.106

Abstract

PURPOSE
To report a case of choroidal metastasis caused by lung cancer in a young female who had no history.
CASE SUMMARY
A 31-year-old female presented with decreased vision for 1 week. Fundus examination revealed an orange colored choroidal tumor and serous retinal detachment at superotemporal area of the optic disc on the left eye. On chest X-ray, atypical pneumonia or hematogenous metastasis was shown. Additionally, mammography, chest-abdomen computed tomography, lumbar magnetic resonance imaging, and transbronchial lung biopsy were performed and the patient was finally diagnosed with adenocarcinoma. The patient started systemic chemotherapy and visual acuity improved after 1 month. Tumor size and subretinal fluid also decreased. The tumor disappeared 2 months later and there was no recurrence.
CONCLUSIONS
There are only few cases in which choroidal metastasis was observed in a young female patient with no history who had decreased visual acuity and was later diagnosed with lung cancer. Authors report this case because a satisfactory result was obtained from chemotherapy alone.

Keyword

Chemotherapy; Choroidal metastasis; Lung cancer

MeSH Terms

Adenocarcinoma
Adult
Biopsy
Choroid*
Citrus sinensis
Drug Therapy
Female
Humans
Lung Neoplasms*
Lung*
Magnetic Resonance Imaging
Mammography
Neoplasm Metastasis*
Pneumonia
Recurrence
Retinal Detachment
Subretinal Fluid
Thorax
Visual Acuity

Figure

• 

  Figure 1. Fundus photography and optical coherence tomography (OCT) of Left eye. (A) Yellow- white choroidal mass was seen. (B) Serous retinal detachment was observed (yellow arrows). (C) OCT shows choroidal mass (dome shaped elevation of neuro-sensory retina and retinal pigmented epithelium). (D) OCT shows serous retinal detachment.

• 

  Figure 2. Ultrasonography of left eye. Dome-shaped mass about 3 mm height was seen (yellow arrow).

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  Figure 3. Fluorescein and Indocyanine green (ICG) angiography of Left eye. (A) Early phase of fluorescein angiography. (B) Latent phase of fluorescein angiography. Fluorescein angiography showing progressive hyperfluorescence in subsequent phases and capillary dilatation at the border of the lesion with pinpoint leakages. (C) Early phase of ICG showing blocked hypofluorescence. (D) Late phase of ICG showing hyperfluorescence at the border of the lesion.

• 

  Figure 4. Chest computed tomography (CT) and magnetic resonance imaging (MRI) of spine. (A) Coronal view of chest CT shows peribronchial and perilymphatic nodules highly suggesting metastasis (yellow arrowheads). (B) MRI of spine shows metastatic os-teoclastic lesion (white arrows).

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  Figure 5. Optical coherence tomography after chemotherapy. (A) 1 month after chemotherapy. Choroidal mass and subretinal fluid (SRF) were improved (B) 13 month after chemotherapy. Choroidal mass and SRF were disappeared.

Reference

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