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Transpupillary thermotherapy for choroidal metastases
N Ardjomand1, M Kucharczyk, G Langmann
1Department of Ophthalmology, Karl Franzens University, Graz, Austria. navid.ardjomand@kfunigraz.ac.at
Summary
Late-developing choroidal metastases from renal cell carcinoma were successfully treated. Transpupillary thermotherapy (TTT) and ruthenium-106 ((106)Ru) plaque radiotherapy effectively managed these asymptomatic ocular tumors.
Area of Science:
- Ophthalmology
- Oncology
- Medical Imaging
Background:
- Renal cell carcinoma (RCC) can metastasize to the choroid, even years after nephrectomy.
- Ocular metastases from RCC are rare but can present asymptomatically.
- This case highlights a 13-year latency period between nephrectomy and choroidal metastasis detection.
Observation:
- A 58-year-old male presented with bilateral asymptomatic choroidal metastases.
- The patient had a history of right nephrectomy for RCC 13 years prior.
- Funduscopic examination revealed tumors in both eyes: small in the right, intermediate in the left.
Findings:
- The right eye tumor was treated with transpupillary thermotherapy (TTT).
- The left eye tumor was treated with ruthenium-106 ((106)Ru) plaque radiotherapy.
- Both tumors showed complete regression to chorioretinal atrophy within 13 months, preserving visual acuity.
Implications:
- Ocular metastases from RCC can occur long after primary tumor treatment.
- TTT and (106)Ru brachytherapy are effective, organ-sparing treatments for choroidal metastases.
- Early detection and prompt treatment are crucial for preserving vision in metastatic disease.