Restoration of vision following combination chemotherapy of nasopharyngeal carcinoma choroidal metastases

Pediatric nasopharyngeal carcinoma with retinal metastasis

PURPOSE

To report an unusual case of nasopharyngeal carcinoma (NPC) metastatic to the lungs and retina. To our knowledge, this is the first report of retinal metastasis from NPC.

DESIGN

Observational case report.

METHODS

We studied the case of a 15-year-old boy who had been recently diagnosed with metastatic NPC and was referred for evaluation of a suspicious retinal lesion in the right eye.

RESULTS

Clinical examination and fundus photography showed an amelanotic, 1-disk-area infiltration in the retina along the inferotemporal arcade that was suggestive of metastatic disease. The lesion was small and irregularly shaped by echographic examination, and a nodular area of retinal thickening was seen by optical coherence tomography. Pathologic analysis of lung biopsy and nasopharynx biopsy specimens revealed undifferentiated NPC.

CONCLUSIONS

Retinal metastases need to be considered in the differential diagnosis of patients presenting with NPC and vision changes.

Emerging treatments for choroidal metastases

It has been over a century since Perls described the first case of choroidal metastasis. For the next six decades only 230 cases were described in the literature. Today, however, ocular metastasis is recognized as the most common intraocular malignancy. Thanks to recent advances in treatment options for metastatic disease, patients are living longer, and choroidal metastases will become an increasingly important issue for oncologists and ophthalmologists alike. We summarize the current knowledge of choroidal metastases and examine their emerging systemic and local therapies. Targeted therapies for metastatic lung, breast, and colon cancer--the most common causes of choroidal metastases--are reviewed in detail with the goal of identifying the most effective treatment strategies.