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Choroidal mass as the presenting sign of small cell lung carcinoma
Bruno F Fernandes1, Luiza Helena Fernandes, Miguel N Burnier
1Department of Ophthalmology, Henry C. Witelson Ophthalmic Pathology Laboratory, McGill University Health Centre, Montreal, Quebec, Canada, and Department of Ophthalmology, Hospital dos Servidores do Estado, Rio de Janeiro, Brazil. brunonet@centroin.com.br
Case Report:
To report the case of a 58-year-old man with blurred vision and metamorphopsia who had an amelanotic choroidal mass in the right eye as the presenting sign of a small cell lung carcinoma. Systemic screening failed to reveal a tumor elsewhere, and the lesion was initially treated as a primary ocular tumor. Discovery of the primary site was made 10 months after the ocular diagnosis, and the patient was then treated with systemic chemotherapy and local radiation therapy.
Comments:
The ophthalmologist has a crucial role not only in the management of ocular metastases but also in the diagnosis of the primary nonocular malignancies that present as a choroidal mass. The possibility of ocular metastases in patients with choroidal masses should always be considered whether or not there is a diagnosis of cancer elsewhere.
Insights
A choroidal mass in the eye was the first sign of small cell lung carcinoma in a patient. Early diagnosis and treatment of ocular metastases are vital for managing non-ocular malignancies.
Area of Science:
- Ophthalmology
- Oncology
Background:
- Small cell lung carcinoma (SCLC) can present with ocular metastases.
- Choroidal masses are a potential sign of metastatic disease.
Observation:
- A 58-year-old man presented with blurred vision and metamorphopsia due to an amelanotic choroidal mass.
- Initial evaluation suggested a primary ocular tumor; systemic screening was negative.
- The primary SCLC was diagnosed 10 months after the ocular findings.
Findings:
- The choroidal mass was the initial presenting sign of previously undiagnosed small cell lung carcinoma.
- Delayed diagnosis of the primary malignancy occurred despite presenting ocular symptoms.
Implications:
- Ophthalmologists play a key role in diagnosing non-ocular malignancies presenting as choroidal masses.
- Ocular metastases should be considered in patients with choroidal masses, even without a prior cancer diagnosis.
