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Iris metastasis: clues to the primary through immunohistochemistry
Mohammed Almanassra1, Soumya Sucharita2, Srikanta Kumar Padhy3
1Ophthalmic Plastic Surgery, Orbit and Ocular Oncology, The Operation Eyesight Universal Institute for Eye Cancer, LV Prasad Eye Institute Bhubaneswar Campus, Bhubaneswar, Odisha, India.
BMJ Case Reports
|April 11, 2025
Summary
A rare case of metastatic lung adenocarcinoma presenting as an iris mass in a woman was diagnosed. This highlights the importance of ocular examination for detecting metastatic cancer, even without typical symptoms.
Area of Science:
- Ophthalmology
- Oncology
- Pathology
Background:
- Metastatic cancer to the iris is uncommon.
- Ocular presentations can be the first sign of an underlying malignancy.
Purpose of the Study:
- To report a case of metastatic lung adenocarcinoma presenting as an iris mass.
- To emphasize the diagnostic role of ocular examination in systemic disease detection.
Main Methods:
- Clinical presentation of an iris mass in a middle-aged woman.
- Excisional biopsy with histopathology and immunohistochemistry.
- Imaging studies including chest CT and PET-CT scans.
Main Results:
- Histopathology confirmed metastatic adenocarcinoma.
- Immunohistochemistry suggested a primary lung origin.
- Imaging revealed a primary lung tumor, metastatic lymph nodes, and brain lesions.
Conclusions:
- An iris mass can be the initial manifestation of metastatic lung adenocarcinoma.
- Prompt ocular and systemic investigations are crucial for diagnosis and management.
- Multidisciplinary care is essential for palliative treatment of advanced metastatic disease.
