A multimodal Approach to the Treatment of Bilateral Choroidal Metastases from Thyroid Carcinoma

Fabrini, Maria Grazia; Genovesi-Ebert, Federica; Perrone, F.; Liguoro, M. de; Giovannetti, Clara; Bogazzi, Fausto; Rizzo, Stanislao; Martino, Enio; Cionini, L.

doi:10.4081/rt.2009.e4

Cited by 6 publications

(1 citation statement)

References 8 publications

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“…However, a number of patients with choroidal metastases originating from a variety of primaries, including the lung, colon and breast, experience progressive metastasis despite undergoing IVB treatment ( 32 ). A previous case report documented the occurrence of intravitreal hemorrhage 20 months after the first IVB injection ( 33 ). The effectiveness, appropriate dosing and long-term outcomes of IVB should therefore be further evaluated.…”

Section: Discussionmentioning

confidence: 99%

Iris metastasis as the first sign of small cell lung cancer: A case report

Liu

Nie

et al. 2017

Oncology Letters

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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.

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Section: Discussionmentioning

confidence: 99%

Iris metastasis as the first sign of small cell lung cancer: A case report

Liu

Nie

et al. 2017

Oncology Letters

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Treatment of ocular metastasis with anti-VEGF: A literature review and case report

Augustine

Munro

Adatia

et al. 2014

Canadian Journal of Ophthalmology

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New concepts in the diagnosis and management of choroidal metastases

Mathis

Jardel

Loria

et al. 2019

Progress in Retinal and Eye Research

112

176

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The most frequent site of ocular metastasis is the choroid. The occurrence of choroidal metastases has increased steadily due to the longer survival of metastatic patients and the improvement of diagnostic tools. Fundoscopy, ultrasonography, and fluorescein angiography are now complemented by indocyanine green angiography and optical coherence tomography. Choroidal tumor biopsy may also confirm the metastatic nature of the tumor and help to determine the site of the primary malignancy. There is currently no consensus on the treatment strategy. Most patients have a limited life expectancy and for these complex treatments are generally not recommended. However, recent advances in systemic therapy have significantly improved survival of certain patients who may benefit from an aggressive ocular approach that could preserve vision. Although external beam radiation therapy is the most widely used treatment, more advanced forms of radiotherapy that are associated with fewer side effects can be proposed in select cases. In patients with a shorter life expectancy, systemic therapies such as those targeting oncogenic drivers, or immunotherapy can induce a regression of the choroidal metastases, and may be sufficient to temporarily decrease visual symptoms. However, they often acquire resistance to systemic treatment and ocular relapse usually requires radiotherapy for durable control. Less invasive office-based treatments, such as photodynamic therapy and intravitreal injection of anti-VEGF, may also help to preserve vision while reducing time spent in medical settings for patients in palliative care. The aim of this review is to summarize the current knowledge on choroidal metastases, with emphasis on the most recent findings in epidemiology, pathogenesis, diagnosis and treatment.

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A multimodal Approach to the Treatment of Bilateral Choroidal Metastases from Thyroid Carcinoma

Cited by 6 publications

References 8 publications

Iris metastasis as the first sign of small cell lung cancer: A case report

Iris metastasis as the first sign of small cell lung cancer: A case report

Treatment of ocular metastasis with anti-VEGF: A literature review and case report

New concepts in the diagnosis and management of choroidal metastases

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