[Ciliary body metastasis as the first sign of small-cell bronchial carcinoma]

About 3-10% of patients suffering from metastatic disease develop metastatic choroidal tumors. In this case report ocular symptoms were the first sign of a systemic malignancy.

A 65-year old man complained of an increasing painful redness of his left eye. He showed a white mass with 10 mm in thickness in the temporal chamber angle with "pseudohypopyon" and secondary glaucoma. Because of increasing pain the eye was removed. Histologic examination showed a small cell carcinoma of the ciliary body with high malignancy, which most probably has to be seen as a metastasis of a carcinoma of the lung, which was detected by internal examination concurrently. In addition, a metastasis in the adrenal gland was found. ACE polychemotherapy was performed, but 4 months later the patient died of metastatic disease with break down of the kidneys.

Based on literature data patients with systemic malignancy present themselves to a physician primarily because of ocular symptoms in 12-31%. In these cases differentiation of an uveal metastasis from a primary amelanotic melanoma can be difficult. The search for primary tumors has to be started in due time.