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UNILATERAL, SECTORAL RETINAL METASTASIS OF SMALL-CELL LUNG CANCER MIMICKING VIRAL RETINITIS.
Melih Ustaoglu1, Ralph J Eagle2, Steven M Bloom3
1Department of Ophthalmology and Visual Sciences, University of Louisville, Louisville, Kentucky.
Retinal Cases & Brief Reports
|April 27, 2023
Summary
Small cell lung cancer (SCLC) can rarely metastasize to the retina, mimicking viral retinitis. This case highlights the importance of considering malignancy in patients with persistent retinal inflammation unresponsive to antiviral treatment.
Area of Science:
- Ophthalmology
- Oncology
- Pathology
Background:
- Small cell lung cancer (SCLC) is an aggressive malignancy with a propensity for metastasis.
- Retinal metastases are rare occurrences in the clinical setting.
- Cytomegalovirus (CMV) retinitis is a common opportunistic infection causing retinal inflammation.
Observation:
- A patient with a history of SCLC presented with unilateral vision loss, initially diagnosed as CMV retinitis.
- The patient did not respond to standard antiviral therapy (valganciclovir, ganciclovir).
- Ocular examination and biopsies ultimately revealed SCLC metastatic to the retina.
Findings:
- Diagnostic vitrectomy confirmed SCLC metastasis to the retina.
- The retinal metastasis mimicked the clinical appearance of CMV retinitis.
- Histopathological misdiagnosis as retinoblastoma is possible without patient history and immunohistochemistry.
Implications:
- Retinal metastasis should be suspected in patients with a history of malignancy presenting with atypical or treatment-refractory viral retinitis.
- Early recognition and diagnosis of retinal metastasis are crucial for appropriate oncological management.
- This case underscores the importance of a thorough patient history and appropriate diagnostic workup in ophthalmology.
