SIMULTANEOUS CHOROIDAL AND RETINAL METASTASES FROM LUNG CARCINOMA

Intraocular metastasis is most commonly found within the choroid because of its luxurious blood supply, whereas metastasis to the retina, from a separate blood supply, is very rare. We report a rare case of synchronous metastases from lung carcinoma to the choroid of the right eye and the retina of the left eye and a complaint of low vision in the right eye.

We report a 63-year-old woman with progressive reduction of vision in her right eye for 1 year without previous history of cancer. The patient underwent comprehensive ophthalmic examination that included a multimodal evaluation: near-infrared reflectance scanning laser ophthalmoscopy, blue autofluorescence, and enhanced-depth imaging spectral domain optical coherence tomography (EDI SD-OCT; Heidelberg Engineering, Heidelberg, Germany).

Ophthalmoscopic examination revealed a yellow choroidal mass measuring 6 × 6 mm with overlying subretinal fluid and involving the macular area in the right eye. In the left eye, there was a superior juxtapapillary yellow-colored mass involving the retina and measuring 1 × 1 mm. Optical coherence tomography revealed the subretinal fluid contouring a dome-shaped choroidal mass in the right eye and intraretinal nodular tumor superior to the optic disk of the left eye. Chest computed tomography revealed a pulmonary nodule measuring 2.5 mm × 1.4 mm, and biopsy of the liver metastasis confirmed the diagnosis of mucinous lung carcinoma.

The final diagnosis was presumed choroidal metastasis in the right eye and retinal metastasis in the left eye from underlying mucinous carcinoma of the lung.