Metastatic adenocarcinoma presenting as bilateral blindness

Area of Science:

• Ophthalmology
• Oncology
• Pathology

Background:

• Metastatic cancer to the eye is uncommon.
• Adenocarcinoma can metastasize to ocular structures.
• Choroidal metastasis can present with varied ocular symptoms.

Observation:

• A 71-year-old male presented with bilateral shallow retinal detachments.
• Initial extensive medical work-up yielded no conclusive diagnosis.
• Computed tomographic-guided "skinny-needle" biopsy of retrocrural lymph nodes was performed.

Findings:

• Biopsy results confirmed metastatic adenocarcinoma.
• The metastasis was identified as the cause of the choroidal involvement.
• This case represents a rare instance of adenocarcinoma metastasizing to the choroid.

Implications:

• This case underscores the importance of considering metastatic disease in unexplained ocular findings.
• Early diagnosis and treatment of choroidal metastasis are crucial for visual preservation.
• A review of metastatic ocular cancer literature is provided for clinical guidance.