1
|
Patidar Y, Saldhana SC, Babu MCS, Jacob LA, Rudresh AH, Lokesh KN, Rajeev LK. Symptomatic orbital metastasis as an initial presentation of adenocarcinoma lung: A case report and review of literature. Lung India 2024; 41:375-378. [PMID: 39215982 DOI: 10.4103/lungindia.lungindia_60_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 06/29/2024] [Indexed: 09/04/2024] Open
Abstract
ABSTRACT Orbital metastasis is a rare entity in oncology. With increasing awareness and advancement, patients with initial ocular presentation can be diagnosed and treated. Ocular metastasis is more common in breast cancer followed by lung cancer. Lung cancer with ocular presentation generally have poor prognosis because of difficult diagnosis, Vision impairment and delayed management. Here, we report one such case of 59 year old female presented with painful periorbital swelling in left eye for 3 months with no pulmonary symptoms. On evaluation, she was diagnosed as ocular metastasis with primary being lung adenocarcinoma. Through this case, we enlighten the epidemiology, presentation, clinical features and evaluation of such patients which might help clinicians in further management.
Collapse
Affiliation(s)
- Yaman Patidar
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology (KMIO), Bengaluru, Karnataka, India
| | | | | | | | | | | | | |
Collapse
|
2
|
Babst N, Gniesmer S, Sonntag SR, Furashova O, Krestanova G, Heindl LM, Müller M, Grisanti S, Kakkassery V. [Clinical approach for solid intraocular metastases]. DIE OPHTHALMOLOGIE 2024; 121:352-365. [PMID: 38649497 DOI: 10.1007/s00347-024-02031-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/20/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Intraocular metastases arising from solid tumors are found in approximately 2% of patients with metastatic tumor diseases and are therefore more frequent than originally assumed. They often affect the uvea and are associated with a poor prognosis. Due to the difficult diagnosis and an inconsistent treatment regimen, ophthalmologists have a special responsibility here. OBJECTIVE This article gives a summary of the various types of intraocular metastases with respect to clinical features, diagnostics, treatment and prognosis as well as recommendations for follow-up care. METHODS A selective literature search was carried out on the topic of intraocular metastases using PubMed and Google Scholar. RESULTS Intraocular metastases most frequently affect the uvea, specifically the choroid. In most cases the underlying disease is breast or lung cancer, but other rarer primary tumors have also been reported in the literature. Metastatic lesions can show very different morphological manifestations but can be distinguished based on the corresponding structure of manifestation in the eye and with the aid of targeted staging, thus providing valid information on the type of primary tumor. The treatment is partly experimental and usually depends on the primary tumor and leading symptoms of the patient. A differentiation between a curative or palliative treatment situation must always be made. CONCLUSION Intraocular metastases are the most frequent intraocular tumor and are usually associated with a poor prognosis. Accurate diagnostics for finding the treatment as well as interdisciplinary collaboration and the presentation of the patient on the tumor board are essential.
Collapse
Affiliation(s)
- Neele Babst
- Klinik für Augenheilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland.
| | - Stefanie Gniesmer
- Klinik für Augenheilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland
| | - Svenja Rebecca Sonntag
- Klinik für Augenheilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland
| | - Olga Furashova
- Klinik für Augenheilkunde, Klinikum Chemnitz, Chemnitz, Deutschland
| | | | - Ludwig Maximilian Heindl
- Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinikum Köln, Universität zu Köln, Köln, Deutschland
- Centrum für Integrierte Onkologie (CIO) Aachen-Bonn-Köln-Düsseldorf, Köln, Deutschland
| | - Martin Müller
- Klinik für Hämatologie, Onkologie und Immunologie, Klinikum Region Hannover, Hannover, Deutschland
| | - Salvatore Grisanti
- Klinik für Augenheilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland
| | - Vinodh Kakkassery
- Klinik für Augenheilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland
- Klinik für Augenheilkunde, Klinikum Chemnitz, Chemnitz, Deutschland
| |
Collapse
|
3
|
Kongwattananon W, Pothikamjorn T, Somkijrungroj T. Posterior segment manifestations of ocular metastasis. Curr Opin Ophthalmol 2023; 34:522-528. [PMID: 37556166 DOI: 10.1097/icu.0000000000000988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
PURPOSE OF REVIEW This article reviewed and summarized recent published data on ocular imaging findings and treatment of posterior segment manifestations of ocular metastasis. RECENT FINDINGS Advanced ocular imaging can help differentiate ocular metastases from other mimicking lesions, including primary intraocular tumors or infections. Recently, case reports have demonstrated the successful use of targeted systemic therapy to achieve local control of vitreous and choroidal metastases. SUMMARY Metastasis can lead to a wide variety of posterior segment ocular manifestations. The choroid is the most common metastatic site, whereas tumor metastasizing to the retina and optic disc are rare. Patients with possible metastatic eye disease are recommended to undergo extensive investigation to determine the underlying primary cancer and ongoing systemic metastases. Currently, there is no consensus on the treatment strategy. Treatment generally includes systemic chemotherapy in combination with local treatment, such as radiotherapy, laser therapy, or anti-vascular endothelial growth factor (anti-VEGF) treatment.
Collapse
Affiliation(s)
- Wijak Kongwattananon
- Center of Excellence in Retina, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Thai Red Cross Society
| | | | - Thanapong Somkijrungroj
- Center of Excellence in Retina, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Thai Red Cross Society
| |
Collapse
|
4
|
Shariati MM, Khazaei S. Choroidal metastasis and bilateral optic nerve involvement as presenting sign of metastatic lung adenocarcinoma: A case report. Clin Case Rep 2023; 11:e7172. [PMID: 37006849 PMCID: PMC10062305 DOI: 10.1002/ccr3.7172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/18/2023] [Accepted: 03/21/2023] [Indexed: 04/01/2023] Open
Abstract
A 49-year-old male presented with a gradually progressive loss of vision in both eyes. Funduscopic examination revealed bilateral optic disc swelling and two yellowish elevated choroidal lesions in the left eye. Ophthalmic imaging raised suspicion of choroidal metastasis. Adenocarcinoma of the lung was detected in further systemic evaluation.
Collapse
Affiliation(s)
| | - Sahel Khazaei
- Eye research centerMashhad University of medical sciencesMashhadIran
| |
Collapse
|
5
|
Liu A, Hefley B, Escandon P, Nicholas SE, Karamichos D. Salivary Exosomes in Health and Disease: Future Prospects in the Eye. Int J Mol Sci 2023; 24:ijms24076363. [PMID: 37047335 PMCID: PMC10094317 DOI: 10.3390/ijms24076363] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/21/2023] [Accepted: 03/24/2023] [Indexed: 03/30/2023] Open
Abstract
Exosomes are a group of vesicles that package and transport DNA, RNA, proteins, and lipids to recipient cells. They can be derived from blood, saliva, urine, and/or other biological tissues. Their impact on several diseases, such as neurodegenerative, autoimmune, and ocular diseases, have been reported, but not fully unraveled. The exosomes that are derived from saliva are less studied, but offer significant advantages over exosomes from other sources, due to their accessibility and ease of collection. Thus, their role in the pathophysiology of diseases is largely unknown. In the context of ocular diseases, salivary exosomes have been under-utilized, thus creating an enormous gap in the literature. The current review discusses the state of exosomes research on systemic and ocular diseases and highlights the role and potential of salivary exosomes as future ocular therapeutic vehicles.
Collapse
Affiliation(s)
- Angela Liu
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, USA
- North Texas Eye Research Institute, University of North Texas Health Science Center, 3430 Camp Bowie Blvd., Fort Worth, TX 76107, USA
| | - Brenna Hefley
- North Texas Eye Research Institute, University of North Texas Health Science Center, 3430 Camp Bowie Blvd., Fort Worth, TX 76107, USA
- Department of Pharmaceutical Sciences, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, USA
| | - Paulina Escandon
- North Texas Eye Research Institute, University of North Texas Health Science Center, 3430 Camp Bowie Blvd., Fort Worth, TX 76107, USA
- Department of Pharmaceutical Sciences, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, USA
| | - Sarah E. Nicholas
- North Texas Eye Research Institute, University of North Texas Health Science Center, 3430 Camp Bowie Blvd., Fort Worth, TX 76107, USA
- Department of Pharmaceutical Sciences, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, USA
| | - Dimitrios Karamichos
- North Texas Eye Research Institute, University of North Texas Health Science Center, 3430 Camp Bowie Blvd., Fort Worth, TX 76107, USA
- Department of Pharmaceutical Sciences, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, USA
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, USA
- Correspondence: ; Tel.: +1-817-735-2101
| |
Collapse
|
6
|
Yamaoka M, Igarashi T, Shiratori N, Miyadera K, Sugano T, Noro R, Takahashi H. A Case of Binocular Metastatic Choroidal Tumor Originating from Pulmonary Adenocarcinoma Successfully Treated with Molecular Target Therapy. Case Rep Ophthalmol 2023; 14:426-432. [PMID: 37901630 PMCID: PMC10601831 DOI: 10.1159/000530130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 02/23/2023] [Indexed: 10/31/2023] Open
Abstract
The occurrence of ocular metastasis from lung cancer is uncommon. In our current case, we report on a 64-year-old male patient found to have metastatic lesions in both choroids after being diagnosed with lung adenocarcinoma. As the patient was found to have a mutation in the epidermal growth factor receptor (EGFR), he was treated with the EGFR tyrosine kinase inhibitor (EGFR TKI), afatinib. However, the treatment response suggested the presence of a progressive disease. Thus, due to cancerous meningitis, the patient's treatment was changed from afatinib to erlotinib, in addition to adding bevacizumab. Although the general condition of the patient did not change, improvement was noted for the choroidal metastasis. Moreover, the drug change also resulted in an improvement of the visual power of both eyes. Therefore, the results for this patient suggest that systemic administration of erlotinib and bevacizumab may be an effective treatment that leads to morphological and functional improvement in choroidal metastasis cases.
Collapse
Affiliation(s)
- Masataka Yamaoka
- Department of Ophthalmology Nippon Medical School Hospital, Tokyo, Japan
| | - Tsutomu Igarashi
- Department of Ophthalmology Nippon Medical School Hospital, Tokyo, Japan
- Department of Ophthalmology Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Naka Shiratori
- Department of Ophthalmology Nippon Medical School Hospital, Tokyo, Japan
| | - Keiki Miyadera
- Department of Respiratory medicine Nippon Medical School Hospital, Tokyo, Japan
| | - Teppei Sugano
- Department of Respiratory medicine Nippon Medical School Hospital, Tokyo, Japan
| | - Rintaro Noro
- Department of Respiratory medicine Nippon Medical School Hospital, Tokyo, Japan
| | - Hiroshi Takahashi
- Department of Ophthalmology Nippon Medical School Hospital, Tokyo, Japan
| |
Collapse
|
7
|
Sudden Vision Loss Secondary to Optic Nerve Infiltration as a Presenting Symptom of Metastatic Lung Adenocarcinoma. Case Rep Ophthalmol Med 2022; 2022:3614225. [DOI: 10.1155/2022/3614225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 10/31/2022] [Indexed: 11/11/2022] Open
Abstract
Purpose. To report a rare case of left-sided metastatic optic nerve infiltration and right-sided choroidal mass with exudative retinal detachment caused by EGFR exon 19 deletion positive non-small-cell lung adenocarcinoma that responded to targeted therapy with osimertinib (EGFR-TKI). Our patient demonstrated an excellent response with reduced size of the metastatic choroidal mass of the right orbit and improved visual acuity, in addition to systemic disease control. Case. A 66-year-old male patient with a history of diabetes mellitus, hypertension, and tobacco use presented with sudden vision loss in the left eye secondary to optic nerve infiltration and subacute vision loss in the right eye secondary to exudative retinal detachment from a choroidal metastasis. He was found to have a right lung mass, multiple metastatic pulmonary nodules, and liver and bone metastases. Biopsy from a mediastinal lymph node confirmed the diagnosis of metastatic lung adenocarcinoma. He was found to have exon 19 deletion on next-generation sequencing. We treated him with local radiation therapy to the left eye and systemic osimertinib (EGFR-TKI). Conclusion. To our knowledge, our case is the first report of a patient who initially presented with acute vision loss and was found to have metastatic retrobulbar optic nerve infiltration in one eye and metastatic choroidal lesion with exudative retinal detachment in the fellow eye secondary to lung adenocarcinoma. Due to the rarity of this condition, literature regarding effective treatment is scarce. Our patient demonstrated significant improvement in visual acuity and resolution of exudative retinal detachment in the right eye following osimertinib treatment and radiation therapy to the left eye. Further investigation into the role of tyrosine kinase inhibitors and radiation therapy in treating intraocular metastasis involving the optic nerve is needed.
Collapse
|
8
|
Giuseppe Agostara A, Curaba A, Carlo Stella G. Iris metastasis from endometrial carcinoma: a challenging diagnosis and individualized eye-sparing treatment. Gynecol Oncol Rep 2022; 44:101098. [DOI: 10.1016/j.gore.2022.101098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/28/2022] [Accepted: 10/30/2022] [Indexed: 11/06/2022] Open
|
9
|
Parakh S, Das S, Maheshwari S, Gupta V, Luthra G, Luthra S. Regression of choroidal metastasis from breast carcinoma with palbociclib. Int J Retina Vitreous 2022; 8:54. [PMID: 35962417 PMCID: PMC9373398 DOI: 10.1186/s40942-022-00398-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 07/11/2022] [Indexed: 11/10/2022] Open
Abstract
Background Uveal metastasis is reported to be the most common intraocular malignancy. The most common site of origin of ocular metastases in females is the breast. In some cases, uveal metastatic lesions respond to systemic chemotherapy. We report a case of a patient who developed choroidal metastasis, while on endocrine therapy with selective estrogen receptor modulator (SERM), tamoxifen, for estrogen receptor (ER) positive, progesterone receptor (PR) positive and (human epidermal growth factor receptor 2) HER2 negative primary breast carcinoma, which then regressed following systemic chemotherapy with palbociclib. Case description An 83-year-old female, with a history of modified radical mastectomy, chemotherapy and radiation therapy for infiltrating duct carcinoma of the breast, presented with a choroidal metastatic lesion in the left eye along with liver and lung metastases, 3 years after the primary carcinoma was treated. At the time of presentation, she was on tamoxifen. The choroidal tumor showed regression after the introduction of palbociclib, a cyclin-dependent kinase 4/6 (CDK4/6) inhibitor. Conclusion This report highlights the use of palbociclib, in the palliative treatment of choroidal metastasis from primary breast cancer. The use of chemotherapy for choroidal metastasis can help avoid external beam radiation therapy and its concurrent side effects. Although there are a few reports involving the use of palbociclib for metastatic breast carcinoma, all of those have been in conjunction with and/or following non-response to other treatment modalities. Ours is the first report wherein palbociclib has been used as the first-line palliative chemotherapy and helped in regression of choroidal metastasis.
Collapse
Affiliation(s)
- Shweta Parakh
- Drishti Eye Institute, 16, Subhash Road, Astley Hall, Dehradun, 248001, Uttarakhand, India
| | - Shrutanjoy Das
- Drishti Eye Institute, 16, Subhash Road, Astley Hall, Dehradun, 248001, Uttarakhand, India
| | - Shrey Maheshwari
- Drishti Eye Institute, 16, Subhash Road, Astley Hall, Dehradun, 248001, Uttarakhand, India
| | | | - Gaurav Luthra
- Drishti Eye Institute, 16, Subhash Road, Astley Hall, Dehradun, 248001, Uttarakhand, India
| | - Saurabh Luthra
- Drishti Eye Institute, 16, Subhash Road, Astley Hall, Dehradun, 248001, Uttarakhand, India.
| |
Collapse
|
10
|
Liu S, Liu X, Wang T, Zeng C, Ren B, Yu X, Xu M, Li W, Qiao Z, You C, Yang Q, Chen M. Effective Systemic Treatment of Choroidal Metastases NSCLC With Surgery After Crizotinib: A Case Report. Front Oncol 2022; 12:789941. [PMID: 35433411 PMCID: PMC9009287 DOI: 10.3389/fonc.2022.789941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 03/02/2022] [Indexed: 11/16/2022] Open
Abstract
Choroidal metastasis as an initial presenting feature of lung cancer with EML4-ALK translocation is exceedingly rare and greatly impacts patient quality of life (QOL). There are no recommended treatments for such patients, and palliative care remains limited. It is unclear whether surgical resection of primary pulmonary lesions, systemic antitumor therapy, targeted therapy, or localized ocular therapy are effective in treating choroidal metastases in EML4-ALK rearranged oligometastatic non-small cell lung cancer (NSCLC). Here, we present the case of choroidal metastases secondary to lung cancer and EML4-ALK translocation in a 57-year-old woman who firstly underwent resection of lung lesions followed by oral administration of crizotinib without local treatment or systemic chemotherapy. Since then she had a rapid and complete response to crizotinib with 27 months of progression-free survival.
Collapse
Affiliation(s)
- Shilan Liu
- Department of Respiratory and Critical Care Medicine, Chengdu Fifth People’s Hospital, Chengdu, China
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiao Liu
- Department of Respiratory and Critical Care Medicine, Chengdu Fifth People’s Hospital, Chengdu, China
| | - Ting Wang
- Lung Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| | - Chunhua Zeng
- Department of Respiratory and Critical Care Medicine, Chengdu Fifth People’s Hospital, Chengdu, China
| | - Baichen Ren
- Department of Respiratory and Critical Care Medicine, Chengdu Fifth People’s Hospital, Chengdu, China
| | - Xiaodan Yu
- Department of Respiratory and Critical Care Medicine, Chengdu Fifth People’s Hospital, Chengdu, China
| | - Min Xu
- Department of Respiratory and Critical Care Medicine, Chengdu Fifth People’s Hospital, Chengdu, China
| | - Wenjuan Li
- Department of Respiratory and Critical Care Medicine, Chengdu Fifth People’s Hospital, Chengdu, China
| | - Zhihui Qiao
- Department of Respiratory and Critical Care Medicine, Chengdu Fifth People’s Hospital, Chengdu, China
| | - Chuanyun You
- Department of Respiratory and Critical Care Medicine, Chengdu Fifth People’s Hospital, Chengdu, China
| | - Qinghui Yang
- Department of Respiratory and Critical Care Medicine, Chengdu Fifth People’s Hospital, Chengdu, China
| | - Mei Chen
- Department of Respiratory and Critical Care Medicine, Chengdu Fifth People’s Hospital, Chengdu, China
| |
Collapse
|
11
|
Visual loss treated with osimertinib: A case report. CURRENT PROBLEMS IN CANCER: CASE REPORTS 2022. [DOI: 10.1016/j.cpccr.2022.100137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
12
|
Kumar P, Kumar A, Dubakka S, Kaushik J, Agrawal M. Unilateral simultaneous optic nerve and choroidal infiltration - unusual presentation of metastatic disease in breast carcinoma. GMS OPHTHALMOLOGY CASES 2021; 11:Doc14. [PMID: 34650902 PMCID: PMC8495234 DOI: 10.3205/oc000187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Breast carcinoma metastasis can involve any ocular structures, but involvement of the optic nerve is extremely rare. Choroidal metastasis is usually multifocal as well as bilateral and occurs late. We report an unusual initial presentation of metastasis from breast cancer; unilateral infiltrative optic neuropathy with concurrent choroid metastatic deposits in an adequately treated middle-aged female. Our present case, wherein for the first time in the literature, we illustrated unilateral infiltrative optic neuropathy and choroidal metastatic deposits secondary to breast carcinoma, will increase our knowledge about the various potential ocular presentations of this relatively common malignant disease.
Collapse
Affiliation(s)
- Poninder Kumar
- Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - Ashok Kumar
- Department of Ophthalmology, Armed Forces Medical College, Pune, India,*To whom correspondence should be addressed: Ashok Kumar, Department of Ophthalmology, Armed Forces Medical College, 411040 Pune, India, E-mail:
| | - Srujana Dubakka
- Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - Jaya Kaushik
- Department of Ophthalmology, Armed Forces Medical College, Pune, India
| | - Mohini Agrawal
- Department of Ophthalmology, Armed Forces Medical College, Pune, India
| |
Collapse
|
13
|
Qu Z, Liu J, Zhu L, Zhou Q. A Comprehensive Understanding of Choroidal Metastasis from Lung Cancer. Onco Targets Ther 2021; 14:4451-4465. [PMID: 34408441 PMCID: PMC8367201 DOI: 10.2147/ott.s315532] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 07/27/2021] [Indexed: 02/05/2023] Open
Abstract
The incidence of lung cancer with intraocular metastasis is low, of which choroidal metastasis is the most painful metastatic lesion. The clinical symptoms resulting from choroidal metastasis from lung cancer easily detected although they are rarely identified prior to the diagnosis of the primary malignancy. The quality of life of patients is inevitably impaired. Some lung cancer patients complain of ocular symptoms as the first manifestation of lung cancer. Early diagnosis and treatment can significantly overcome or delay the visual impairment and improve prognosis. The main therapeutic modalities include systemic and local treatments, while observation is also a treatment option. Currently, the feasibility and effectiveness of various treatment options are controversial worldwide. Herein, we summarize the underlying mechanisms, epidemiology, clinical features, auxiliary examinations, diagnosis, and recent treatment options for intraocular metastases.
Collapse
Affiliation(s)
- Zihan Qu
- Lung Cancer Center, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Jiewei Liu
- Lung Cancer Center, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Lingling Zhu
- Lung Cancer Center, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Qinghua Zhou
- Lung Cancer Center, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| |
Collapse
|
14
|
Mitamura M, Kase S, Suimon Y, Ito T, Ishida S. A Case of Metastatic Iris Tumor Observed With Anterior Segment Optical Coherence Tomography Before and After Radiation Therapy. In Vivo 2021; 34:2159-2162. [PMID: 32606198 DOI: 10.21873/invivo.12023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 04/17/2020] [Accepted: 04/18/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Metastatic iris tumors are relatively rare entities that are often treated with radiation therapy; however, it remains difficult to evaluate the effectiveness of treatment. Anterior segment optical coherence tomography (AS-OCT) provides high-resolution cross-sectional images with no dye injection, and may thus be useful for evaluating iris tumors. Herein, we report a case of metastatic iris tumor examined with AS-OCT before and after radiation therapy. CASE REPORT A 56-year-old Japanese woman complained of ocular hyperemia and pain in her right eye, and was referred to our hospital because of uveitis and an iris mass. One year before the initial visit, the patient was diagnosed with lung adenocarcinoma, and treated with chemotherapy. She also underwent radiation therapy 4 months ago due to multiple bone metastases. Slit-lamp microscopy revealed a 2×2 mm elevated lesion with partial depigmentation on the lower iris. AS-OCT examination revealed that the mass was located in the iris stroma with an irregular anterior surface. Based on fine needle aspiration cytology, she was diagnosed with metastatic iris tumor derived from lung adenocarcinoma, leading to local radiotherapy. Seven months later, AS-OCT showed shrinkage and atrophy of the iris tumor with peripheral anterior synechia formation. CONCLUSION We report a case of cytology-proven metastatic iris tumor observed with AS-OCT before and after radiation therapy. This study highlights the potential usefulness of AS-OCT for monitoring changes in tumor size and configuration following radiotherapy.
Collapse
Affiliation(s)
- Mizuho Mitamura
- Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.,Department of Ophthalmology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Satoru Kase
- Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yuka Suimon
- Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Takako Ito
- Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Susumu Ishida
- Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| |
Collapse
|
15
|
Salcedo-Villanueva G, Medina-Andrade AA, Moreno-Paramo D, Golzarri MF, Moreno-Paramo E, Ortiz-Ramirez GY, Martinez-Aguilar U, De Dios-Cuadras U, Jimenez-Rodriguez M, Espinosa-Soto I, Mira-Lorenzo X, Guzman-Cerda J, Orozco-Moguel A, Becerra-Revollo C, Orozco-Gomez LP, Fulda E. Primary Cancer Sites and Clinical Features of Choroidal Metastasis in Mexican Patients. Clin Ophthalmol 2021; 15:201-209. [PMID: 33500613 PMCID: PMC7826071 DOI: 10.2147/opth.s285250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 12/01/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To describe the primary cancer sites and clinical features of choroidal metastasis in Mexican patients. Methods This was a retrospective, observational, and multi-center study. Data were recollected from 6 ophthalmological hospitals in Mexico from patients with choroidal metastasis diagnosed from 2000 to 2018. Results Seventy-eight patients were studied: 43 were female and 35 were male. Mean age at presentation was 57.6 years. Overall, primary cancer sites were: 1) breast: 27 cases (34.6%); 2) lung: 19 cases (24.3%); 3) unknown: 8 cases (10.2%); 4) gastrointestinal: 7 cases (8.9%); 5) renal: 5 cases (6.4%); 6) testicular: 3 cases (3.8%); 7) ovary: 3 Cases (3.8%); 8) prostate: 2 cases (2.5%); 9) thyroid: 2 cases (2.5%); 10) carcinoid: 1 case (1.2%); and 11) multiple myeloma: 1 case (1.2%). Divided by gender, for women, the main three sites were: breast, unknown, and ovary. For men, the main three sites were: lung, gastrointestinal, and testicular. Oldest cases were breast cancer (87 and 85 years); youngest cases were testicular (23 and 25 years). Solitary lesions were observed in 56 cases (71.7%); multiple lesions were observed in 22 cases (28.2%). Forty-two cases had a white or yellowish color, while 6 cases presented an orange color. Conclusion Primary cancer sites and clinical features of choroidal metastasis in Mexican patients show important differences from other populations previously studied, mainly the presence of a higher proportion of gastrointestinal and renal cancer, as well as higher incidence of ovarian and testicular cancer. These types of cancer, although not as common as breast or lung, need to be taken into account when studying Mexican patients living abroad.
Collapse
Affiliation(s)
- Guillermo Salcedo-Villanueva
- Retina Department, Asociación Para Evitar la Ceguera en México, Hospital "Dr. Luis Sánchez Bulnes", Mexico City, Mexico
| | | | - Daniel Moreno-Paramo
- Ophthalmology Department, Hospital General de México "Dr. Eduardo Liceaga", Mexico City, Mexico
| | - Maria Fernanda Golzarri
- Retina Department, Asociación Para Evitar la Ceguera en México, Hospital "Dr. Luis Sánchez Bulnes", Mexico City, Mexico
| | - Edel Moreno-Paramo
- Retina Department, Asociación Para Evitar la Ceguera en México, Hospital "Dr. Luis Sánchez Bulnes", Mexico City, Mexico
| | - Grecia Yael Ortiz-Ramirez
- Retina Department, Asociación Para Evitar la Ceguera en México, Hospital "Dr. Luis Sánchez Bulnes", Mexico City, Mexico
| | - Ursula Martinez-Aguilar
- Retina Department, Instituto de Oftalmología Fundación Conde de Valenciana, Mexico City, Mexico
| | - Ulises De Dios-Cuadras
- Retina Department, Instituto de Oftalmología Fundación Conde de Valenciana, Mexico City, Mexico
| | | | - Itzel Espinosa-Soto
- Retina Department, Fundación Hospital Nuestra Señora de la Luz, Mexico City, Mexico
| | - Ximena Mira-Lorenzo
- Retina Department, Instituto Mexicano de Oftalmología, Santiago de Queretaro, Mexico
| | - Juvenal Guzman-Cerda
- Retina Department, Instituto Mexicano de Oftalmología, Santiago de Queretaro, Mexico
| | | | - Catalina Becerra-Revollo
- Retina Department, Asociación Para Evitar la Ceguera en México, Hospital "Dr. Luis Sánchez Bulnes", Mexico City, Mexico
| | | | - Emiliano Fulda
- Retina Department, Instituto de Oftalmología Fundación Conde de Valenciana, Mexico City, Mexico
| |
Collapse
|
16
|
Cruzado-Sanchez D, Saavedra-Mejia LA, Tellez WA, Maquera-Torres G, Serpa-Frias S. Metastatic Intraocular Tumor Due to Colorectal Adenocarcinoma: Case Report and Literature Review. J Ophthalmic Vis Res 2020; 15:565-570. [PMID: 33133448 PMCID: PMC7591836 DOI: 10.18502/jovr.v15i4.7794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 01/13/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose To describe the clinical and histopathological findings of a case of intraocular metastasis due to colorectal adenocarcinoma and to carry out a literature review. Case Report A 64-year-old man with a history of tumor resection due to infiltrating colorectal adenocarcinoma three years previously sought ophthalmological care because of severe ocular pain without response to medical treatment and progressive vision loss in the left eye. On ultrasonographic examination, there was a heterogeneous intraocular choroidal tumor, which occupied approximately 40% of the vitreous cavity, as well as peritumoral serous retinal detachment. The patient underwent left eyeball enucleation. The histopathological diagnosis was metastatic tubular adenocarcinoma involving the retina and choroid that partially infiltrated the sclera and the proximal optic nerve. Conclusion The present case highlights a rare pathological entity associated with variable therapeutic schemes and survival times and poor prognosis in patients with metastatic intraocular tumors due to colorectal adenocarcinoma.
Collapse
Affiliation(s)
- Deivy Cruzado-Sanchez
- Ophthalmic Oncology Service, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Luis A Saavedra-Mejia
- Sociedad Científica de Estudiantes de Medicina Villarrealinos, Universidad Nacional Federico Villarreal, Lima, Peru
| | - Walter A Tellez
- Sociedad Científica de Estudiantes de Medicina Villarrealinos, Universidad Nacional Federico Villarreal, Lima, Peru
| | | | - Solon Serpa-Frias
- Ophthalmic Oncology Service, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| |
Collapse
|
17
|
Lee KE, Yeo JH, Kim YJ, Kim JG, Yoon YH, Kwon DH, Cho YH, Lee JY. Short-term Effect of Gamma Knife Radiosurgery for a Choroidal Tumor. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2020. [DOI: 10.3341/jkos.2020.61.10.1156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
18
|
Lin L, Sun J, Wang J. Lung cancer and intraocular metastasis in gestation: Clinical experiences of a rare case. Thorac Cancer 2020; 11:2723-2726. [PMID: 32691515 PMCID: PMC7471047 DOI: 10.1111/1759-7714.13572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/23/2020] [Accepted: 06/26/2020] [Indexed: 12/29/2022] Open
Abstract
Lung cancer in pregnancy combined with intraocular metastasis rarely occurs and has a poor prognosis. Here, we report an extremely rare case of a 31-year-old non-smoking pregnant female who was diagnosed with lung adenocarcinoma with multiple metastasis including choroidal metastasis. Whole exon sequencing was performed but no appropriate therapeutic target was identified. The patient received standard pemetrexed plus carboplatin for first-line treatment after delivery. Ophthalmic treatment including transpupillary thermotherapy and intravitreal ranibizumab injections were administered and the patient responded very well to treatment. Her visual acuity was restored, indicating systemic therapy combined with ophthalmic treatment was an appropriate choice of therapy. KEY POINTS: SIGNIFICANT FINDINGS OF THE STUDY: The case reported here of a pregnant female diagnosed with lung cancer with choroidal metastasis highlights the aggressive characteristics of the disease. WHAT THIS STUDY ADDS: Systemic therapy in combination with ocular therapy is an appropriate choice of treatment.
Collapse
Affiliation(s)
- Lin Lin
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Sun
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie Wang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
19
|
Delayed lung adenocarcinoma metastasis to the choroid in a non-end-stage cancer patient. Can J Ophthalmol 2020; 55:e144-e146. [PMID: 32081374 DOI: 10.1016/j.jcjo.2020.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 12/18/2019] [Accepted: 01/12/2020] [Indexed: 11/20/2022]
|
20
|
A rare case of non-small cell lung cancer choroidal metastasis responding to ALK tyrosine kinase inhibitors. Anticancer Drugs 2020; 31:90-94. [DOI: 10.1097/cad.0000000000000848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
21
|
Akinci GE, Hondur AM, Tezel TH. MANAGEMENT OF METASTATIC BREAST CARCINOMA OF IRIS WITH INTRAOCULAR BEVACIZUMAB INJECTIONS. Retin Cases Brief Rep 2019; 13:220-223. [PMID: 28346258 DOI: 10.1097/icb.0000000000000584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
PURPOSE To describe intraocular use of bevacizumab for a metastatic breast carcinoma of the iris resistant to advanced systemic chemotherapy protocols, for which conventional treatment would be local radiotherapy or brachytherapy. METHODS Case report. RESULTS A 65-year-old woman, who was previously diagnosed with breast carcinoma and treated with radical mastectomy coupled with radiotherapy and chemotherapy, presented with an iris mass in her left eye. Four successive intravitreal injections of bevacizumab resulted in progressive regression of the tumor to an almost indiscernible size at 8 months, along with blunting of the highly complex tumor vascular network on fluorescein angiography. At 12 months, the patient's visual acuity remained 20/20, and no ocular or systemic adverse effects were encountered. CONCLUSION Intravitreal bevacizumab can offer a simpler and safer solution to treat metastatic iris tumors compared with other treatment options. This report of bevacizumab for treating iris metastasis from breast carcinoma may broaden the treatment options for similar neoplasms of the iris.
Collapse
Affiliation(s)
- G Ece Akinci
- Edward Harkness Institute of Ophthalmology, Columbia University Medical Center, New York, New York
| | | | | |
Collapse
|
22
|
Yalcinbayir O, Gelisken O, Sen F, Yasar S, Alizadegan F. RETINAL METASTASIS FROM SQUAMOUS CELL CARCINOMA OF THE LUNG: A CASE PRESENTATION. Retin Cases Brief Rep 2019; 13:141-144. [PMID: 28221259 DOI: 10.1097/icb.0000000000000553] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND/PURPOSE To present a case with retinal metastasis from squamous cell carcinoma of the lung. METHODS Case report. RESULTS A 54-year-old man presented with blurry vision in his left eye. His medical history was significant for Stage IV squamous lung carcinoma. He was undergoing chemotherapy and had a known metastasis. He had a slightly elevated whitish lesion associated with retinal hemorrhages in the left posterior pole. Optical coherence tomography showed a full-thickness retinal mass. No involvement of the choroid could be detected. Further investigation demonstrated a de novo metastasis in the right frontal lobe of the brain. CONCLUSION The lesion showed remarkable regression with subsequent systemic chemotherapy.
Collapse
Affiliation(s)
| | | | - Feyza Sen
- Nuclear Medicine, Uludag University School of Medicine, Bursa, Turkey
| | | | | |
Collapse
|
23
|
Noronha V, Talreja V, Joshi A, Patil V, Mahajan A, Prabhash K. The story of two eyes- What to look for in the patient's eyes? CANCER RESEARCH, STATISTICS, AND TREATMENT 2019. [DOI: 10.4103/crst.crst_57_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
|
24
|
Hernández-Ayuso I, Rodríguez-Reyes AA, Ríos y Valles-Valles D, Kawakami-Campos PA, Herrera Cifuentes SL. Just another metastatic carcinoid tumour to the uveal tract. Saudi J Ophthalmol 2018; 32:355-357. [PMID: 30581312 PMCID: PMC6300787 DOI: 10.1016/j.sjopt.2018.02.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 02/15/2018] [Accepted: 02/17/2018] [Indexed: 12/19/2022] Open
Abstract
We describe the clinic, image, and histopathologic features of a well differentiated neuroendocrine carcinoma (carcinoid tumour) metastatic to choroid and ciliary body in a 52-year-old Mexican Mestizo man. The ophthalmologic examination showed an inferior choroidal mass accompanied by exudative retinal detachment. Ultrasound B-Scan study revealed a diffuse thickened choroid with overlying serous retinal detachment, ultrasound A-Scan revealed a high internal reflectivity solid lesion. Ultrasound biomicroscopy (UBM) evidenced a dome shaped ciliary body mass, presumptive diagnosis was uveal tract metastatic disease. Scleral flap choroidal incisional biopsy was performed. Microscopic evaluation demonstrated a hypercellular lesion replacing choroid, composed by cohesive oval-round cells with finely granular chromatin arranged in organoid pattern. Immunohistochemical reactions were Pankeratin AE1/AE3 (+), Cytokeratin CK5/6 (+), Chromogranin A (+), Ki67 (20%), typical well differentiated neuroendocrine carcinoma (carcinoid tumour) was diagnosed. Patient had a mediastinal carcinoid diagnosed 3 years earlier. Metastatic cancer to the eye is perhaps the leading cause of intraocular tumour, despite this fact metastases are rarely seen by the ophthalmologist while the patient is alive. Intraocular metastasis should be considered in the presence of ciliary body or/and choroidal amelanotic or pigmented mass and serous retinal detachment in a patient with history of carcinoid tumor, althought its low frequency (2.2%).
Collapse
Affiliation(s)
- Ivette Hernández-Ayuso
- Ophthalmic Pathology Service, Ophthalmologist, Ophthalmic Pathologist, Asociación para Evitar la Ceguera en México I.A.P “Hospital Dr. Luis Sánchez Bulnes”, Mexico City, Mexico
- Corresponding author at: Asociación para Evitar la Ceguera en México, “Hospital Dr. Luis Sánchez Bulnes”, Vicente García Torres No. 46, Barrio San Lucas Coyoacán, Ciudad de México 04030, Mexico. Fax: +52 (55) 10841400x1210.
| | - Abelardo A. Rodríguez-Reyes
- Ophthalmic Pathology Service, Anatomic Pathologist, Ophthalmic Pathologist, Asociación para Evitar la Ceguera en México I.A.P “Hospital Dr. Luis Sánchez Bulnes”, Mexico City, Mexico
| | - Dolores Ríos y Valles-Valles
- Ophthalmic Pathology Service, Anatomic Pathologist, Ophthalmic Pathologist, Asociación para Evitar la Ceguera en México I.A.P “Hospital Dr. Luis Sánchez Bulnes”, Mexico City, Mexico
| | - P. Ayumi Kawakami-Campos
- Retina Service, Ophthalmologist, Vitreo-Retinal Surgeon, Asociación para Evitar la Ceguera en México I.A.P “Hospital Dr. Luis Sánchez Bulnes”, Mexico City, Mexico
| | - Sharon L. Herrera Cifuentes
- Pathology Service, Anatomic Pathologist, Ophthalmic Pathologist, “Hospital Español de México”, Mexico City, Mexico
| |
Collapse
|
25
|
Arya M, Duker JS. Vinorelbine-induced regression of a choroidal metastasis from primary breast carcinoma. Int J Retina Vitreous 2018; 4:17. [PMID: 29785284 PMCID: PMC5950186 DOI: 10.1186/s40942-018-0121-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 04/16/2018] [Indexed: 11/30/2022] Open
Abstract
Background Various therapeutic options exist to treat choroidal metastatic lesions. However, they are all associated with potential long-term adverse effects. This case report discusses a case of choroidal metastasis from primary breast carcinoma that regressed after single-agent chemotherapy. Case presentation We report a case of choroidal metastasis from estrogen receptor (ER) positive breast carcinoma that became resistant to endocrine therapy. The primary malignancy was treated with surgical resection and adjuvant chemoradiation, followed by hormone therapy with various agents in combination with kinase inhibitors for ER resistance. The choroidal metastatic lesion regressed after the initiation of vinorelbine. Vinorelbine is a cytotoxic vinca alkaloid with tolerable systemic adverse effects. Conclusions This case report highlights the possible role of vinorelbine as a single chemotherapeutic agent for the conservative therapy of uveal metastasis from advanced breast carcinoma, irrespective of responsiveness to hormone therapy.
Collapse
|
26
|
Photodynamic Therapy in Ocular Oncology. Biomedicines 2018; 6:biomedicines6010017. [PMID: 29414877 PMCID: PMC5874674 DOI: 10.3390/biomedicines6010017] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 01/08/2018] [Accepted: 01/30/2018] [Indexed: 01/15/2023] Open
Abstract
Although introduced for the treatment of maculopathies, photodynamic therapy (PDT) is now largely used in some eye cancers treatment. The selective tissue damage with PDT is achieved by sequestration of the photosensitizer in the target tissue and focal activation of the photosensitizer by low energy directed light. In this way, it is possible to achieve the destruction of the tumor tissue by safeguarding the surrounding healthy structures. Our study describes the clinical uses and efficacy of photodynamic therapy in ocular oncology.
Collapse
|
27
|
Métastase irienne d’un carcinome prostatique : à propos d’un cas. J Fr Ophtalmol 2018; 41:e63-e65. [DOI: 10.1016/j.jfo.2017.05.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 05/02/2017] [Accepted: 05/05/2017] [Indexed: 10/17/2022]
|
28
|
Abstract
A 68-year-old woman with a recent history of blurring in the left eye had undergone mastectomy for breast cancer 20 years ago. A series of bone metastases started 5 years after her diagnosis. Examination of the optic nerve head of the left eye revealed an isolated peripapillary mass. Indocyanine green angiography displayed vessels within the mass, and fluorescein angiography demonstrated hyperfluorescence of the mass from vascular leakage plus lobular spots of blocked fluorescence. B-scan ultrasound revealed a hyperechoic-elevated nodular mass on the optic disc. Spectral-domain optical coherence tomography displayed a mass of spherules. Magnetic resonance imaging of the brain demonstrated metastatic tumors. She was diagnosed with an optic disk metastasis from her breast carcinoma.
Collapse
|
29
|
Funazo T, Morita K, Ikegami N, Konishi C, Nakao S, Ariyasu R, Taki M, Nakagawa K, Hwang MH, Yoshimura C, Wakayama T, Nishizaka Y. Successful Treatment with Alectinib for Choroidal Metastasis in Anaplastic Lymphoma Kinase Rearranged Non-small Cell Lung Cancer. Intern Med 2017; 56:2317-2320. [PMID: 28794371 PMCID: PMC5635306 DOI: 10.2169/internalmedicine.8488-16] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Choroidal metastasis is rare in cancer patients and it may cause visual disturbances that reduce their quality of life. In non-small cell lung cancer (NSCLC), targeted therapy against actionable driver mutations has gradually replaced radiotherapy as the treatment of choice for choroidal metastasis. Recently, there have been several case reports of choroidal metastasis in patients with anaplastic lymphoma kinase (ALK)-rearranged NSCLC. We herein report the case of a 40-year-old Japanese woman diagnosed with choroidal metastasis of an ALK-rearranged NSCLC who received alectinib as the first-line chemotherapy. Alectinib may be the best treatment for choroidal metastasis in patients harboring an ALK translocation because of its favorable side effect profile involving visual disturbances.
Collapse
Affiliation(s)
- Tomoko Funazo
- Department of Respiratory Medicine, Kyoto University, Japan
| | - Kyohei Morita
- Department of Respiratory Medicine, Osaka Red Cross Hospital, Japan
| | - Naoya Ikegami
- Department of Respiratory Medicine, Osaka Red Cross Hospital, Japan
| | - Chisato Konishi
- Department of Respiratory Medicine, Osaka Red Cross Hospital, Japan
| | - Satoshi Nakao
- Department of Respiratory Medicine, Osaka Red Cross Hospital, Japan
| | - Ryo Ariyasu
- Department of Respiratory Medicine, Osaka Red Cross Hospital, Japan
| | - Masato Taki
- Department of Respiratory Medicine, Osaka Red Cross Hospital, Japan
| | | | - Moon Hee Hwang
- Department of Respiratory Medicine, Osaka Red Cross Hospital, Japan
| | - Chie Yoshimura
- Department of Respiratory Medicine, Osaka Red Cross Hospital, Japan
| | | | - Yasuo Nishizaka
- Department of Respiratory Medicine, Osaka Red Cross Hospital, Japan
| |
Collapse
|
30
|
Shah RK, Lamichhane S. Ocular metastasis from breast carcinoma simulating anterior scleritis: a case report. J Med Case Rep 2017; 11:249. [PMID: 28844204 PMCID: PMC5572158 DOI: 10.1186/s13256-017-1416-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 07/20/2017] [Indexed: 11/18/2022] Open
Abstract
Background Breast cancer is one of the commonest sources of ocular metastasis. Patients with ocular metastatic disease can present with a variable clinical picture. Patients with a history of breast cancer presenting with any eye symptom should be evaluated with consideration of ocular metastasis. Case presentation We report a case of ocular metastasis in a 46-year-old Brahmin woman presenting with right eye pain. She had been treated for stage IIIc left-sided breast cancer 2 years ago with six cycles of chemotherapy with docetaxel, adriamycin, and cyclophosphamide after undergoing modified radical mastectomy. An ophthalmic examination revealed a tender subconjunctival swelling superotemporally on retracting right upper eyelid. This finding alone indicated anterior scleritis. On examining fundus under mydriasis, an amelanotic subretinal mass could be visualized in the posterior pole superotemporal to macula. An orbital magnetic resonance imaging revealed a mass of 2 × 1 cm in size in the subretinal space of her right eye. Computed tomography of her chest was then done and showed multiple metastases in both lungs. Conclusion This case report highlights the fact that any unusual ocular presentation, even one simulating anterior scleritis, in a patient with a history of breast cancer should raise suspicion of metastasis.
Collapse
Affiliation(s)
- Ritesh Kumar Shah
- Department of Ophthalmology, Childrens' Hospital for Eye, ENT and Rehabilitation Services (CHEERS), Bhaktapur, Kathmandu, Nepal
| | - Samir Lamichhane
- Department of Clinical Pharmacology, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
| |
Collapse
|
31
|
Fukuda S, Fujiwara Y, Mishima H, Wakasa T, Hanamoto H, Inoue K, Kitani K, Ishikawa H, Tsujie M, Yukawa M, Okajima K, Ohta Y, Inoue M. Choroidal metastasis from granulocyte colony-stimulating factor-producing esophageal squamous cell carcinoma: a case report. Clin Case Rep 2017; 5:419-424. [PMID: 28396760 PMCID: PMC5378863 DOI: 10.1002/ccr3.853] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 01/20/2017] [Indexed: 01/21/2023] Open
Abstract
Granulocyte colony‐stimulating factor (G‐CSF)‐producing esophageal squamous cell carcinoma (ESCC) is rare. Esophageal cancer is a highly aggressive disease and often spreads hematogenously; however, choroidal metastases are rarely seen. This report detailed an extremely rare case of G‐CSF‐producing ESCC with choroidal metastasis.
Collapse
Affiliation(s)
- Shuichi Fukuda
- Department of Gastroenterological Surgery Kindai University Nara Hospital Nara Japan
| | - Yoshinori Fujiwara
- Department of Gastroenterological Surgery Kindai University Nara Hospital Nara Japan
| | - Hiroshi Mishima
- Department of Ophthalmology Kindai University Nara Hospital Nara Japan
| | - Tomoko Wakasa
- Department of Pathology Kindai University Nara Hospital Nara Japan
| | - Hitoshi Hanamoto
- Department of Hematology Kindai University Nara Hospital Nara Japan
| | - Keisuke Inoue
- Department of Gastroenterological Surgery Kindai University Nara Hospital Nara Japan
| | - Kotaro Kitani
- Department of Gastroenterological Surgery Kindai University Nara Hospital Nara Japan
| | - Hajime Ishikawa
- Department of Gastroenterological Surgery Kindai University Nara Hospital Nara Japan
| | - Masanori Tsujie
- Department of Gastroenterological Surgery Kindai University Nara Hospital Nara Japan
| | - Masao Yukawa
- Department of Gastroenterological Surgery Kindai University Nara Hospital Nara Japan
| | - Kaoru Okajima
- Department of Radiology Kindai University Nara Hospital Nara Japan
| | - Yoshio Ohta
- Department of Pathology Kindai University Nara Hospital Nara Japan
| | - Masatoshi Inoue
- Department of Gastroenterological Surgery Kindai University Nara Hospital Nara Japan
| |
Collapse
|
32
|
Liu SL, Nie YH, He T, Yan XX, Xing YQ. Iris metastasis as the first sign of small cell lung cancer: A case report. Oncol Lett 2017; 13:1547-1552. [PMID: 28454289 PMCID: PMC5403398 DOI: 10.3892/ol.2017.5648] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 09/16/2016] [Indexed: 11/24/2022] Open
Abstract
The current study documents an unusual case of iris metastasis as the first sign of small cell lung cancer (SCLC) and reviews the relevant literature to increase understanding and awareness of this rare condition. A 59-year-old male chronic smoker presented with a painful and red right eye without any disturbance of vision. The patient also complained of associated chronic cough and anorexia. Upon examination, an exfoliative, pinkish-white lesion of the right iris was observed. A systemic work-up was performed, which incidentally detected metastatic SCLC in the lower lobe of the right lung and was confirmed by histopathological examination. A thorough evaluation demonstrated no organ metastases, except in the iris. Following the failure of conservative approaches, the eye had to be enucleated. The clinical features, treatment and prognosis of this condition are briefly reviewed and the results of contrast-enhanced ultrasound (CEUS) examination observed in this case are presented. Despite their rarity, iris lesions should be considered as possible manifestations of underlying malignancies. Imaging techniques, particularly CEUS, may aid the detection, diagnosis and monitoring of such lesions.
Collapse
Affiliation(s)
- Shi-Liang Liu
- Eye Center, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Yu-Hong Nie
- Eye Center, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Tao He
- Eye Center, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Xi-Xi Yan
- Eye Center, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Yi-Qiao Xing
- Eye Center, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| |
Collapse
|
33
|
Oh JH, Ko SJ, Yang YS, Choi CW. A Case of Choroidal Metastasis Caused by Lung Cancer. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2017. [DOI: 10.3341/jkos.2017.58.1.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jae Hyun Oh
- Department of Ophthalmology, Wonkwang University School of Medicine, Iksan, Korea
- Institute of Wonkwang Medical Science, Wonkwang University, Iksan, Korea
| | - Sang Jun Ko
- Department of Ophthalmology, Wonkwang University School of Medicine, Iksan, Korea
- Institute of Wonkwang Medical Science, Wonkwang University, Iksan, Korea
| | - Yun Sik Yang
- Department of Ophthalmology, Wonkwang University School of Medicine, Iksan, Korea
- Institute of Wonkwang Medical Science, Wonkwang University, Iksan, Korea
| | - Chang Wook Choi
- Department of Ophthalmology, Wonkwang University School of Medicine, Iksan, Korea
- Institute of Wonkwang Medical Science, Wonkwang University, Iksan, Korea
| |
Collapse
|
34
|
Makabe K, Kurishima K, Shiozawa T, Miyazaki K, Ohara G, Kagohashi K, Satoh H, Hizawa N. Treatment of choroid metastasis from lung adenocarcinoma with bevacizumab-containing chemotherapy: A case report. Exp Ther Med 2016; 11:239-242. [PMID: 26889247 DOI: 10.3892/etm.2015.2893] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 02/03/2015] [Indexed: 11/06/2022] Open
Abstract
The occurrence of ocular metastasis from lung cancer is uncommon. The present study reports the case of a 69-year-old female patient with lung adenocarcinoma who was found to have a metastatic lesion in the left choroid at the time of presentation. As the patient was found to have a mutation in the epidermal growth factor receptor, treatment with gefitinib was administered; however, the response was evaluated as a progressive disease. Thereafter, the patient received chemotherapy with carboplatin, pemetrexed and bevacizumab. Radiological imaging revealed shrinkage of the primary lesion and choroidal metastasis, and the visual power of the left eye was also shown to improve. Therefore, the present case report demonstrated the efficacy and safety of systemic bevacizumab therapy in combination with a platinum doublet for the treatment of choroid metastasis, with morphological and functional improvements observed with regard to the choroidal metastatic tumor.
Collapse
Affiliation(s)
- Kenichi Makabe
- Division of Ophthalmology, Mito Medical Center, University of Tsukuba, Mito, Ibaraki 310-0015, Japan
| | - Koichi Kurishima
- Division of Respiratory Medicine, Mito Medical Center, University of Tsukuba, Mito, Ibaraki 310-0015, Japan
| | - Toshihiro Shiozawa
- Division of Respiratory Medicine, Mito Medical Center, University of Tsukuba, Mito, Ibaraki 310-0015, Japan
| | - Kunihiko Miyazaki
- Division of Respiratory Medicine, Mito Medical Center, University of Tsukuba, Mito, Ibaraki 310-0015, Japan
| | - Gen Ohara
- Division of Respiratory Medicine, Mito Medical Center, University of Tsukuba, Mito, Ibaraki 310-0015, Japan
| | - Katsunori Kagohashi
- Division of Respiratory Medicine, Mito Medical Center, University of Tsukuba, Mito, Ibaraki 310-0015, Japan
| | - Hiroaki Satoh
- Division of Respiratory Medicine, Mito Medical Center, University of Tsukuba, Mito, Ibaraki 310-0015, Japan
| | - Nobuyuki Hizawa
- Division of Respiratory Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| |
Collapse
|
35
|
Okuma Y, Tanaka Y, Kamei T, Hosomi Y, Okamura T. Alectinib for choroidal metastasis in a patient with crizotinib-resistant ALK rearranged positive non-small cell lung cancer. Onco Targets Ther 2015; 8:1321-5. [PMID: 26082648 PMCID: PMC4461085 DOI: 10.2147/ott.s83179] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Choroidal metastasis is rare in cancer patients. Small molecules of molecular targeted agents for lung cancer with actionable mutations were reported to be palliated for symptoms caused by choroidal metastasis. Visual disturbance by choroidal metastasis significantly decreases quality of life during the patient’s remaining lifespan; therefore, radiotherapy or laser photocoagulation is proposed with consensus. However, improvement in survival with matched molecular targeted agents for oncogenic driver mutations reminds us to also be concerned with late treatment toxicities. A 30-year-old female patient previously treated with crizotinib harboring ALK rearranged non-small cell lung cancer complained of visual disturbance, fever, and bone pains undergoing anti-PD-1 antibody treatment. A decreased proportion of ALK fusion was demonstrated by fluorescence in situ hybridization in liver metastasis compared to the primary site in a chemo-naïve state. She was diagnosed with low vision, choroidal metastasis and retinal detachment. Therefore, she started alectinib treatment and both her ocular and systemic symptoms were palliated in a week. Later, she temporarily discontinued alectinib because of skin rash although the choroidal metastasis and retinal detachment resolved and she regained low vision completely at 2 weeks. She obtained partial response with alectinib for more than 5 months after recovering from skin rash.
Collapse
Affiliation(s)
- Yusuke Okuma
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, The Jikei University School of Medicine, Tokyo, Japan ; Division of Oncology, Research Center for Medical Sciences, The Jikei University School of Medicine, Tokyo, Japan
| | - Yuichiro Tanaka
- Department of Ophthalmology, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, Tokyo, Japan
| | - Tina Kamei
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, The Jikei University School of Medicine, Tokyo, Japan
| | - Yukio Hosomi
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, The Jikei University School of Medicine, Tokyo, Japan
| | - Tatsuru Okamura
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, The Jikei University School of Medicine, Tokyo, Japan
| |
Collapse
|
36
|
Iris metastasis from esophageal squamous cell carcinoma: A case report. Oncol Lett 2015; 10:790-792. [PMID: 26622571 DOI: 10.3892/ol.2015.3255] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 05/12/2015] [Indexed: 11/05/2022] Open
Abstract
Carcinoma metastatic to the eye is a rare condition, typically associated with a poor prognosis. Breast and lung cancers are the most common sources of intraocular metastases, and the majority of metastatic lesions involve the posterior uvea, with <8% of reported cases arising in the iris. Intraocular metastasis as the presenting form of esophageal carcinoma is highly uncommon. In the present report, a rare case of metastatic iris tumor resulting from esophageal squamous cell carcinoma is discussed. A 64-year-old patient presented with a progressively distending pain in the right eye, with associated blurred vision. Local and systemic evaluation was performed, followed by treatment. Multiple examinations identified a neoplasm in the right iris and postoperative pathology revealed that the iris lesion was a metastasis of esophageal squamous cell cancer origin. The patient was treated with adjuvant radiation. To the best of our knowledge, this was only the second reported case of esophageal squamous cell carcinoma metastasizing to the iris.
Collapse
|
37
|
Ophthalmic Metastasis of Breast Cancer and Ocular Side Effects from Breast Cancer Treatment and Management: Mini Review. BIOMED RESEARCH INTERNATIONAL 2015; 2015:574086. [PMID: 26078956 PMCID: PMC4442260 DOI: 10.1155/2015/574086] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Revised: 04/01/2015] [Accepted: 04/12/2015] [Indexed: 11/18/2022]
Abstract
Breast cancer is one of the most common malignant diseases occurring in women, and its incidence increases over the years. It is the main site of origin in ocular metastatic disease in women, and, due to its hematogenous nature of metastatic spread, it affects mainly the uveal tissue. The purpose of this paper is to summarize the clinical manifestations of the breast cancer ocular metastatic disease, alongside the side effects of the available treatment options for the management and regression of the systematic and ophthalmic disease.
Collapse
|
38
|
Complete Disappearance of Choroidal Metastasis from Lung Adenocarcinoma Treated with Bevacizumab and Chemotherapy. Case Rep Ophthalmol Med 2015; 2015:142408. [PMID: 26064733 PMCID: PMC4439491 DOI: 10.1155/2015/142408] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 02/28/2015] [Accepted: 03/10/2015] [Indexed: 11/23/2022] Open
Abstract
Choroidal metastasis from lung cancer is uncommon. We report a case of choroidal metastasis as an inaugural manifestation of lung adenocarcinoma, successfully treated by docetaxel, cisplatinum, and intravenous bevacizumab as an antiangiogenesis therapy. A complete remission was obtained after 4 cycles and maintained after six cycles. This case report demonstrates the importance of the systemic bevacizumab and chemotherapy in the treatment of choroidal metastasis from adenocarcinoma of the lung.
Collapse
|
39
|
Uveal metastasis from nonsmall cell lung carcinoma with dramatic response to erlotinib. Retin Cases Brief Rep 2014; 4:390-3. [PMID: 25390927 DOI: 10.1097/icb.0b013e3181e180e6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To report the case of a never-smoker patient whose initial presentation of metastatic nonsmall cell lung carcinoma was with uveal metastasis, which had a dramatic response to targeted biologic therapy with erlotinib (Tarceva) after failing conventional chemotherapy. METHODS Case report. A 43-year-old man with uveal metastasis from nonsmall cell lung adenocarcinoma. RESULTS After failing conventional chemotherapy with carboplatin and taxol, with continued documented rapid growth of the uveal metastasis, treatment was initiated with the targeted biologic agent, erlotinib, which is a protein tyrosine kinase inhibitor of the epidermal growth factor receptor(EGFR). Within 3 days of starting erlotinib, shrinkage of the choroidal lesion was noted, and over the course of the next 3 months, the tumor completely and durably disappeared, with vision improving from hand motion to 20/25. The patient is still alive and well after 3 years, on continued daily oral erlotinib treatment. CONCLUSION Erlotinib is a well-tolerated newly available Food and Drug Administration-approved oral targeted biologic agent, which may be beneficial in some patients with uveal metastasis from nonsmall cell lung carcinoma, in which an underlying epidermal growth factor receptor mutation is suspected.
Collapse
|
40
|
Choroidal and cutaneous metastasis from urothelial carcinoma of the bladder after radical cystectomy: a case report and literature review. Case Rep Urol 2014; 2014:491541. [PMID: 25431734 PMCID: PMC4241253 DOI: 10.1155/2014/491541] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 10/21/2014] [Indexed: 11/17/2022] Open
Abstract
Bladder cancer is the second most common genitourinary malignancy and has variable metastatic potential; however, choroidal and cutaneous metastases are extremely rare. Generally, a patient with these uncommon metastases has a very poor prognosis. We present a bladder cancer patient with a visual disorder in the right eye and multiple nodules on head and lower abdomen that developed 17 months after a radical cystectomy. These symptoms were determined to be caused by choroidal and cutaneous metastasis of bladder cancer. Although two cycles of combination chemotherapy were performed, the patient died 5 months after diagnosis of multiple metastases.
Collapse
|
41
|
Jebb A, Hadden P, Broom RJ. Uveal metastasis and myasthenia gravis in a patient with recurrent renal cell carcinoma treated with pazopanib. Clin Genitourin Cancer 2014; 12:e143-6. [PMID: 24656526 DOI: 10.1016/j.clgc.2014.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 02/12/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Abbey Jebb
- Department of Medical Oncology, Auckland City Hospital, Auckland, New Zealand.
| | - Peter Hadden
- Department of Ophthalmology, Auckland City Hospital, Auckland, New Zealand
| | - Reuben J Broom
- Department of Medical Oncology, Auckland City Hospital, Auckland, New Zealand
| |
Collapse
|
42
|
Maturu VN, Singh N, Bansal P, Rai Mittal B, Gupta N, Behera D, Gupta A. Combination of intravitreal bevacizumab and systemic therapy for choroidal metastases from lung cancer: report of two cases and a systematic review of literature. Med Oncol 2014; 31:901. [PMID: 24604338 DOI: 10.1007/s12032-014-0901-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 02/25/2014] [Indexed: 11/30/2022]
Abstract
Symptomatic choroidal metastasis (SCM) is an uncommon manifestation of lung cancer (LC). Treatment of SCM usually includes a combination of systemic therapy (chemotherapy and/or targeted therapy) for the primary tumor as well as local therapy (ocular radiation) for CM. Intravitreal bevacizumab (IV-Bev) is a newer modality being tried for local control of SCM. We describe here two patients with LC who presented with CM and were treated with IV-Bev. We performed a systematic literature review of previously reported patients with CM from LC who were treated with IV-Bev. Six reports (involving seven patients) in which IV-Bev was used as primary treatment modality for CM from LC were identified in the systematic literature review. A total of nine patients (seven previously reported and two index cases) were analyzed further. Along with individual case descriptions of index patients, pooled analysis of demographic profile, histology and outcomes with treatment (systemic and ocular) for the nine patients identified in this systematic review are described. A majority (n = 7) had non-small-cell lung cancer (NSCLC) histology, CM as presenting manifestation (n = 6) and unilateral ocular involvement (n = 8). IV-Bev was used in a dose of either 1.25 mg/cycle (n = 5) or 2.5 mg/cycle (n = 4) with number of cycles varying from 2 to 14 and duration between cycles varying from 2 to 8 weeks. Of the nine patients treated with IV-Bev as the primary ocular treatment modality, six (all non-squamous NSCLC) had favorable ocular response. No short-term ocular complications related to therapy were noted. We suggest that IV-Bev is a promising and safe alternative to ocular radiation for initial treatment of CM from non-squamous NSCLC. However, we recommend against using it for patients with small-cell lung cancer.
Collapse
Affiliation(s)
- Venkata Nagarjuna Maturu
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh, 160012, India
| | | | | | | | | | | | | |
Collapse
|
43
|
Jiang K, Brownstein S, Sekhon HS, Laurie SA, Lam K, Gilberg S, Britton W. Ocular metastasis of lung adenocarcinoma with ELM4-ALK translocation: A case report with a review of the literature. Saudi J Ophthalmol 2013; 27:187-92. [PMID: 24227984 DOI: 10.1016/j.sjopt.2013.06.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Choroidal metastasis is the most common intraocular neoplasm and is associated with significant morbidity. In a small percentage of patients, ocular manifestation may be the initial presentation of a systemic malignancy and can be diagnostically difficult to distinguish from ocular primary malignancies. Herein, we present a case of a never-smoker whose ocular pathology was integral to the diagnosis and management of a lung adenocarcinoma harboring a rare oncogene. Through this case, we have explored important diagnostic and therapeutic considerations of pulmonary metastases to the choroid.
Collapse
Affiliation(s)
- Kailun Jiang
- Department of Ophthalmology, University of Ottawa, The Ottawa Hospital, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada ; Department of Pathology and Laboratory Medicine, University of Ottawa, The Ottawa Hospital, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | | | | | | | | | | | | |
Collapse
|
44
|
The effect of chemotherapy with cisplatin and pemetrexed for choroidal metastasis of non-squamous cell carcinoma. Cancer Chemother Pharmacol 2013; 73:199-205. [PMID: 24202667 DOI: 10.1007/s00280-013-2341-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 10/25/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE Choroidal metastasis from lung cancer is very rare in the clinical setting. Treatment for lung cancer with symptomatic choroidal metastasis remains uncertain because of the rarity of such cases. METHODS We performed a retrospective study on symptomatic choroidal metastasis from lung cancer at the Kaohsiung Medical University Hospital from January 2010 to August 2011. In addition, we also performed literature review of all such patients (or of cancers with choroidal metastasis) treated with systemic chemotherapy. RESULTS In our study, a total of 226 lung cancer patients were registered during the study period, and only four had choroidal metastasis (4/226, 1.77 %). Three were female (75 %) and one was male, with a mean age of 40.74 (range 26-60) years. Three patients had marked choroidal tumor regression after treatment with pemetrexed and cisplatin. In the literature reviews, there are only 12 patients (including our patients) received systemic chemotherapy alone instead of local therapy and eight (66.7 %) demonstrated choroidal tumor regression after treatment. CONCLUSIONS Symptomatic choroidal metastasis from lung cancer is extremely rare. Our findings indicate that systemic chemotherapy with pemetrexed and cisplatin may be a good option for such patients. Further large-scale studies for the treatment of such patients are warranted. However, currently, radiotherapy is still the gold standard for such patients.
Collapse
|
45
|
Konstantinidis L, Rospond-Kubiak I, Zeolite I, Heimann H, Groenewald C, Coupland SE, Damato B. Management of patients with uveal metastases at the Liverpool Ocular Oncology Centre. Br J Ophthalmol 2013; 98:92-8. [PMID: 24169654 DOI: 10.1136/bjophthalmol-2013-303519] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Uveal metastasis is the most common intraocular malignancy. METHODS This was a retrospective study of all patients with uveal metastases referred to the Liverpool Ocular Oncology Centre between January 2007 and December 2012. Biopsy was performed as a primary investigation if the clinical examination suggested metastasis with no evidence of any extraocular metastases. RESULTS Ninety-six patients (109 eyes) were included. Breast and lung carcinomas were the most common primary malignancies, affecting 41 and 27 patients, respectively. The median time interval between detection of primary cancer and uveal metastasis was 24 months (range 1-288 months). Thirty-nine patients underwent ocular biopsy, confirming the diagnosis in all patients. The biopsy indicated the site of origin in 24 out of the 27 without a known primary tumour. In 7 of these 27 cases, previous systemic investigations had failed to identify the primary tumour. Seventy-three patients received external beam irradiation; two patients received photodynamic therapy; and two patients had Ru-106 plaque radiotherapy. The visual acuity was stable or improved in 75.5% of the cases. CONCLUSIONS Immediate biopsy provides a quick diagnosis that may expedite treatment and improve any opportunities for conserving vision while facilitating the general oncologic management on these patients.
Collapse
|
46
|
Khan F, Mahmalji W, Sriprasad S, Madaan S. Prostate cancer with metastases to the kidney: a rare manifestation of a common disease. BMJ Case Rep 2013; 2013:bcr2012008388. [PMID: 23907962 PMCID: PMC3762516 DOI: 10.1136/bcr-2012-008388] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 66-year-old Caucasian man with a background of prostate cancer presented with a progressive history of nausea, reduced appetite, shortness of breath and a distended abdomen. Radiological imaging revealed a left-sided renal mass and gross ascites suggestive of metastatic renal cell carcinoma (RCC). Subsequent histological examination and immunostaining of renal mass biopsy revealed features characteristic of metastatic moderately differentiated to a focally poorly differentiated, large duct type of prostatic adenocarcinoma.
Collapse
Affiliation(s)
- Fahd Khan
- Department of Urology, Darent Valley Hospital, Kent, Dartford, UK.
| | | | | | | |
Collapse
|
47
|
Lefresne S, Fairchild A, Johnson R, Deschenes J, Russell L, Pederson J. Genitourinary malignancy presenting as an ocular metastasis: A case report and review of the literature. Can Urol Assoc J 2012; 6:E67-71. [PMID: 22511437 DOI: 10.5489/cuaj.10174] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Metastases to the eye or orbit as the initial presentation of genitourinary malignancy are unusual and can be a diagnostic challenge. We report an 81-year-old man who presented with pain and proptosis in an eye that had been blind for 50 years. Radiologic investigations identified a mass involving the left globe and orbit. Histology of the enucleation specimen was consistent with a metastatic poorly differentiated carcinoma suggestive of a prostate primary. With the constellation of obstructive urinary symptoms, an abnormal digital rectal examination, elevated prostate-specific antigen and a positive bone scan, androgen deprivation therapy was initiated for metastatic prostate cancer. After an initial response to treatment, the patient's disease progressed in a manner atypical for prostate cancer. After describing our case, we review the literature on ocular and orbital metastases and their relation to genitourinary malignancies.
Collapse
Affiliation(s)
- Shilo Lefresne
- Department of Radiation Oncology, BC Cancer Agency, Vancouver, BC
| | | | | | | | | | | |
Collapse
|
48
|
Singh N, Kulkarni P, Aggarwal AN, Mittal BR, Gupta N, Behera D, Gupta A. Choroidal metastasis as a presenting manifestation of lung cancer: a report of 3 cases and systematic review of the literature. Medicine (Baltimore) 2012; 91:179-194. [PMID: 22732948 DOI: 10.1097/md.0b013e3182574a0b] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Symptomatic choroidal metastasis is a rare presenting manifestation of lung cancer. We describe here 3 patients with non-squamous non-small cell lung cancer who presented with choroidal metastasis and who were diagnosed and treated by the authors. We performed a systematic literature review of the previously reported patients with choroidal metastasis from lung cancer in the English-language literature. We excluded case series lacking individual patient data and identified 75 patients. In 23 of these patients, choroidal metastasis was not the presenting manifestation of lung cancer. Therefore, we included 55 patients (3 index and 52 previously reported) in the analysis. We present the demographic profile, histology, disease stage, ocular and lung lesions, diagnostic and treatment (systemic and ocular) modalities, and treatment outcomes. The majority of patients were male (67.3%) and were current or ex-smokers (78.3%); the mean age was 55.1 (standard deviation 11.2) years. Adenocarcinoma (n = 23) was the most common histologic type followed by squamous (n = 11) and small cell (n = 8). Left eye (n = 32) involvement was more common than right eye (n = 19) or bilateral (n = 4). Among patients for whom the location of primary lesion was specified, the left upper lobe (n = 13) was the most common site. The most common diagnostic modalities were bronchoscopic lung biopsy (n = 15) and enucleation (n = 13), while the liver (30.9%) was the most common extraocular metastatic site identified. Systemic chemotherapy was given in 56.4% of cases, and disease progression was the most common outcome among evaluable patients. Ocular treatment modalities included radiation (n = 23), enucleation (n = 14), and systemic steroids (n = 8). Regression of choroidal metastases with treatment was observed in 66.7% of patients who did not undergo enucleation as the primary treatment modality. Of the 3 index patients, 2 each received pemetrexed-cisplatin (as first-line therapy), gefitinib or erlotinib (as second- or third-line therapy), and intravitreal bevacizumab; and 1 patient received systemic bevacizumab. Two patients had partial response radiologically with systemic treatment, and all 3 patients had regression of choroidal metastases with ocular treatment. Recommendations regarding systemic and local (ocular) management of patients with choroidal metastasis as the presenting manifestation of lung cancer are provided.
Collapse
Affiliation(s)
- Navneet Singh
- From Departments of Pulmonary Medicine (NS, ANA, DB), Ophthalmology (PK, AG), Nuclear Medicine (BRM), and Cytology and Gynecological Pathology (NG), Postgraduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh, India
| | | | | | | | | | | | | |
Collapse
|
49
|
Mansour AM, Alameddine R. Intravitreal bevacizumab for consecutive multiple choroidal breast metastatic lesions. BMJ Case Rep 2012; 2012:bcr.03.2012.6124. [PMID: 22707687 DOI: 10.1136/bcr.03.2012.6124] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 49-year-old woman presented with visual loss in the right from optic nerve metastatic disease and asymptomatic choroidal lesion at the inferior arcade. Throughout 22 months of follow-up, she developed a total of five different sequential choroidal metastases to the left eye that were non-responsive to chemotherapy but showed prompt tumour regression by fundus examination and fluorescein angiography within 2 weeks after a single intravitreal bevacizumab. The control of the lesion with a single intravitreal injection of bevacizumab reflects the superior choroidal bioavailability of the drug. The persistence of subretinal fluid at the site of prior metastases may be thought to be one sign of persistence of malignant cells, but in the current case and in the literature, it seems a reflection of a diseased retinal pigment epithelium with probable damage from the tumour invasion.
Collapse
Affiliation(s)
- Ahmad M Mansour
- Ophthalmology Department, American University of Beirut, Beirut, Lebanon.
| | | |
Collapse
|
50
|
Complete regression of a non-small cell lung cancer choroidal metastasis with intravitreal bevacizumab. J Thorac Oncol 2012; 7:468-9. [PMID: 22252564 DOI: 10.1097/jto.0b013e3182398f7b] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|