Choroidal metastasis of non-small cell lung cancer that responded to gefitinib
Iwao Shimomura1, Yuji Tada, Gen Miura
1Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba 260-8677, Japan.
Abstract:
A 52-year-old Japanese woman presented with optical symptoms, including left-sided myodesopsia, blurred vision, narrowed visual field, and diminished visual acuity. Ocular evaluation revealed a metastatic tumor in the choroid. Further examinations identified pulmonary adenocarcinoma as the primary tumor. Because an epidermal growth factor receptor gene (EGFR) mutation was detected in a biopsy specimen, gefitinib treatment was initiated. Dramatic responses were obtained in the primary tumor and metastatic foci. Optical symptoms improved and remained stable for 5 months during the treatment, until relapse. This report demonstrates that gefitinib is effective for choroidal metastasis of pulmonary adenocarcinoma harboring an EGFR mutation.
Insights
Gefitinib effectively treated choroidal metastasis from lung cancer with an EGFR mutation, improving vision symptoms. This targeted therapy offers a promising option for ocular metastases in specific lung adenocarcinoma cases.
Area of Science:
- Oncology
- Ophthalmology
- Genetics
Background:
- Choroidal metastasis can significantly impair vision.
- Pulmonary adenocarcinoma is a common primary cancer with metastatic potential.
- Epidermal Growth Factor Receptor (EGFR) mutations are key drivers in some lung cancers.
Purpose of the Study:
- To evaluate the efficacy of gefitinib in treating choroidal metastasis from pulmonary adenocarcinoma.
- To assess the impact of gefitinib on ocular symptoms and tumor burden.
- To highlight the role of EGFR mutation status in guiding treatment decisions.
Main Methods:
- Case report of a 52-year-old Japanese woman with ocular symptoms.
- Diagnosis of choroidal metastasis from pulmonary adenocarcinoma.
- EGFR mutation analysis of tumor biopsy.
- Treatment with gefitinib and monitoring of response.
Main Results:
- Gefitinib treatment led to a dramatic response in both primary lung tumor and choroidal metastatic lesions.
- Significant improvement in visual symptoms including blurred vision and narrowed visual field.
- Symptomatic improvement and stability were maintained for 5 months before relapse.
Conclusions:
- Gefitinib is an effective treatment for choroidal metastasis in pulmonary adenocarcinoma harboring an EGFR mutation.
- Targeted therapy based on genetic profiling can yield significant clinical benefits in metastatic cancer.
- This case underscores the importance of considering systemic treatment for ocular metastases.
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