Choroidal metastases and exudative retinal detachment in medullary thyroid carcinoma

The uvea is the most common site for ocular metastasis. Within this, the choroid is commonly involved as compared with the iris and the ciliary body. This is due to the distribution of blood supply, which is greater in the choroid than in the iris and ciliary body. Ocular metastasis mostly occurs from breast and lung cancer. Choroidal metastasis from thyroid carcinoma is rare. The gold standard test for diagnosis of choroidal metastasis is fluorescein angiography. We present the case of a man in his early 30s who reported a concern of diminished vision in the right eye for 2 weeks. Fundus examination revealed a localised elevated hypopigmented lesion superiorly and exudative retinal detachment inferiorly. The patient has already been diagnosed with stage 4 medullary thyroid carcinoma, underwent thyroidectomy and is currently on chemotherapy. MRI showed widely scattered metastatic lesions in the brain, orbit, liver, lungs and pancreas.