Unilateral blindness as a presenting symptom of lung cancer treated with erlotinib

A non-smoker young man presented to the ophthalmologist with loss of vision in his left eye. Clinical work-up revealed metastatic deposits in left retina. Broadened workup also showed metastatic disease in the skull and brain. The search for the primary concluded on the histopathological evidence of Non-Small Cell Lung Carcinoma (NSCLC) in the upper lobe of the left lung. After the diagnosis and ascertaining disease extent, localized radiotherapy to whole skull and retina was given, followed by conventional chemotherapy (Gemcitabine, Carboplatin). The results of radiation and chemotherapy were not satisfactory, therefore, patient was placed on a new agent (tyrosine kinase inhibitor) Erlotinib (150 mg per day orally in a single dose). The response was evaluated using clinical and radiological parameters and was found to be satisfactory.