[Eye involvement in cancer]

Intraocular metastatic tumors are rare. They are seen in 10% of patients having died of a malignant tumor. Frequently metastatic tumors of the eye are not observed clinically because the may develop in the terminal stage of the disease. The most frequent primary tumor is carcinoma of the breast with 60% of all intraocular metastatic tumors followed bronchogenic carcinoma with 19%. While breast carcinomas usually metastasize years after excision of the primary tumor, bronchogenic carcinomas may metastasize into the eye before the primary tumor reveals itself. Corresponding with its blood supply the choroid, particularly the posterior pole, is the most frequent manifestation of a metastatic tumor of the eye. Here they show the picture of an ill defined, light, slightly prominent, round tumor with irregularities of the overlying retinal pigment epithelium. They are occasionally misinterpreted as amelanotic malignant melanomas of the choroid, nevi, hemangiomas or rhegmatogenous retinal detachment. The prognosis is poor. Once a metastatic tumor has manifested itself within the eye the life expectation is 7-9 months. Orthovolt radiation with a dose of 30 Gy fractioned over 2-3 weeks may be successful. Chemotherapy has not been very satisfactory. We have seen metastatic tumors of the choroid that developed during chemotherapy. Ophthalmologists are not used to the contact with cancer patients. These patients require special care. The relatives should be included in the discussions because they suffer as well and may be very helpful in the further maintenance of the patient. It is recommended to advise the same doctor to care for the patient because this will build up confidence and trust.