Abstract
A 56-year-old male patient complaining of productive cough, hoarseness, and fatigue was found to have extensive disease of small cell lung cancer (ED-SCLC), with staging of cT4N3M1(PUL). He was treated with chemotherapy. While undergoing treatment with chemotherapy, he complained of a right visual disturbance, and choroidal metastasis was diagnosed. Because the primary site responded well to chemotherapy alone and the visual disturbance did not worsen, the patient refused radiotherapy to the choroidal metastasis. Two months after the first diagnosis of the choroidal metastasis, while he was receiving the first treatment regimen for SCLC, the visual disturbance suddenly worsened; emergent radiotherapy was started, with a total dose of 40 Gy, given as 2.0 Gy/fraction per day. The visual disturbance never improved, and the patient lost 80% of his right visual field. Within 6 months of diagnosis, the patient became blind in his right eye. The patient died of septic shock related to treatment received during his third chemotherapy regimen. Choroidal metastasis is very rare with extraocular malignant tumors, though it is common with intraocular malignant tumors. Choroidal metastasis secondary to SCLC has a poor prognosis, but in order to maintain quality of life during the patients’ remaining lifespan, aggressive treatment would appear appropriate for these patients, because SCLC is a chemo-sensitive cancer.
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References
Godtfredsen E (1944) On frequency of secondary carcinoma in the choroid. Acta Ophthalmol 22:394–400
Albert DM, Rubenstein RA, Scheie HG (1967) Tumor metastasis to the eye, part 1. Incidence in 213 adult patients with generalized malignancy. Am J Ophtalmol 63:723–726
Bloch RS, Gartner S (1971) The incidence of ocular metastatic carcinoma. Arch Ophthalmol 85:673–675
Nelson CC, Hertzberg BS, Klintworth GK (1983) A histopathologic study of 716 unselected eyes in patients with cancer at the time of death. Am J Ophthalmol 95:788–793
Kreusel KM, Wiegel T, Stange M, et al. (2002) Choroidal metastasis in disseminated lung cancer: frequency and risk factors. Am J Ophthalmol 134:445–447
Shields CL, Shields JA, Gross NE, et al. (1997) Survey of 520 eyes with uveal metastasis. Ophthalmology, 104:1265–1276
Kobayashi M, Ikezoe T, Uemura Y, et al. (2007) Long-term survival of a patient with small cell lung cancer associated with cancer-associated retinopathy. Lung Cancer 57:399–403
Kashiwabara K, Nakamura H, Kishi K, et al. (1999) Cancer-associated retinopathy during treatment for small-cell lung carcinoma. Intern Med 38:597–601
Bidegain C, Rigalt J, Ribot E, et al. (2005) Small cell lung cancer and cancer-associated retinopathy. Arch Bronconeumol 41:99–101
Sakaguchi S, Isobe K, Hamanaka N, et al. (2008) A case of choroidal metastasis as an initial manifestation of lung cancer successfully treated with gefitinib (in Japanese). Jpn J Lung Cancer 48: 123–129
Kosmas C, Malamos NA, Antonopoulos M (2000) Complete regression of choroidal metastases from breast cancer after docetaxel-based systemic chemotherapy. Med Pediatr Oncol 34: 229–230
Ino K, Mitui T, Nomura S, et al. (2001) Complete remission of gestational choriocarcinoma with choroidal metastasis treated with systemic chemotherapy alone: case report and review of literature. Gynecol Oncol 83:601–604
Rosset A, Zoggrafos L, Coucke P, et al. (1998) Radiotherapy of choroidal metastases. Radiother Oncol 46:263–268
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Okuma, Y., Hosomi, Y., Kitamura, K. et al. Choroidal metastasis in a patient with small cell lung cancer discovered during treatment with chemotherapy. Int J Clin Oncol 14, 541–544 (2009). https://doi.org/10.1007/s10147-009-0881-8
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DOI: https://doi.org/10.1007/s10147-009-0881-8