Bilateral choroidal metastasis from non-small cell lung cancer

Diagnostic of small choroidal metastasis

Choroidal metastasis in 23–30 % of cases have multifocal growth. In 10–20 % of patients do not have subjective complaints, due to eccentrical localization of choroidal metastases. In these cases, they are detected by chance during examination. In the literature there is no information on the possibility of early diagnosis of “small” foci of metastatic lesions of the choroid using optical coherence tomography (OCT).The aim. To identify diagnostic signs of “small” choroidal metastases.Materials and methods. The study included 4 patients in whom “small” metastases (15 foci) were not visualized by ultrasound.Results. Choroidal metastases, which were not detected by ultrasound, mainly characterized by a multifocal growth pattern, and located mainly outside the central regions of the fundus. The OCT picture in these cases was characterized by the expansion of the choroidal complex up to 1300 μm with an asymmetric shape of the slopes, irregularities of its anterior surface with a moderate hyporeflective structure. At the same time, Bruch’s membrane was preserved, but a violation of the architectonics of the choriocapillary layer is characteristic with a flat profile of the anterior surface of the sclera. Secondary changes in the proper retina are represented by thickening of the retinal pigment epithelium, edema of the photoreceptor layer and of the nuclear layers, while neuroepithelium detachment (NED) appears mainly when the focus is more than 400 μm thick. Initially, choroidal metastasis can be detected by the fundus examination in MultiColor and OCT, as changes appear in the retina – edema of the photoreceptor layer with hyperreflective inclusions and NED, changes appear in the blue-peak autofluorescence (BAF) – hyperBAF with point hypoBAF inclusions, which leads to a change fundus pictures in MultiColor mode.Conclusion. For all patients with a burdened oncological history, even in the absence of visual complaints, in addition to an examination of the fundus of both eyes, it is necessary to provide an examination of the fundus in MultiColor and short-wave autofluorescence modes, followed by OCT in the zones of changes.

CA-125, CA-153, and CYFRA21-1 as clinical indicators in male lung cancer with ocular metastasis

Despite recent improvements in diagnosis and therapy, lung cancer remains the most common malignant tumor in males, with high morbidity and mortality. As the annual incidence continues to increase worldwide, the prognosis for male patients with lung cancer remains unsatisfactory. Interestingly, smoking is associated with lung cancer and ocular lesions by altering risk factors such as carbohydrate antigen (CA)-125, CA-153 and cytokeratin-19 fragment (CYFRA21-1). A diagnostic standard for serum biomarker levels of ocular metastasis (OM) in males with lung cancer is therefore urgently needed. In this retrospective analysis, we examined the relationship between smoking preference and OM in male patients with lung cancer to identify an independent prognostic factor or establish a quantitative indicated standard for OM using the clinical indexes from 2238 cases of male lung cancer. The combination of CA-125, CA-153 and CYFRA21-1 could help diagnose OM in male lung cancer patients. This finding might lead to more timely diagnosis and effective therapies.

Choroidal metastasis as the initial presentation of lung adenocarcinoma: A case report

Clinical reports of symptomatic choroidal metastasis as the initial presentation of lung cancer are rare. Here, we report such a presentation in a female patient of non small cell lung cancer. She presented with loss of vision in her left eye. On further analyses, the patient was diagnosed with a lung adenocarcinoma.

Choroidal Metastasis as Initial Presentation in Adenocarcinoma of Lung: A Case Report

Vision impairment as an initial presentation detecting choroid metastasis in primary lung cancer is rare. Prevention or treatment of visual loss and improvement in quality of life can be achieved by treatment of intraocular metastasis. The survival of the patient in choroid metastasis with lung primary is poor with the median survival being 3.3 months. However, proper treatment may increase the quality of life and survival to an extent. We report a case of adenocarcinoma of lung in a female patient, presented initially with visual impairment as a result of choroidal metastasis and treated with external beam radiotherapy for choroidal metastasis followed by palliative chemotherapy. The patient was survived with improved vision and quality of life since last 12 months of diagnosis.