Unilateral choroidal metastases as an unusual presentation of small cell lung cancer

The choroid, rich in vasculature, is a common site for ocular metastases, predominantly from breast and lung cancer. Unlike breast cancer, which may cause bilateral involvement, lung cancer typically leads to unilateral lesions. Adenocarcinoma is the primary lung cancer subtype associated with choroidal metastasis, while small cell lung cancer (SCLC) infrequently involves the choroid. In our case, a 69-year-old man with hypertension, hyperlipidemia, and chronic obstructive pulmonary disease presented with right eye visual disturbances and was diagnosed with choroidal metastasis. Subsequent imaging revealed lung cancer with widespread metastasis. Despite treatment postponement due to deteriorating health, the patient's condition worsened, leading to palliative care discharge. Despite its rarity, choroidal involvement in SCLC warrants further investigation to enhance diagnostic and therapeutic strategies. This case highlights the importance of meticulous evaluation and interdisciplinary care to optimize outcomes in patients with SCLC and choroidal metastasis.