Isolated Vitreous Metastasis in a Patient With an Anaplastic Lymphoma Kinase–positive Lung Cancer Treated With Lorlatinib

Abstract

Purpose: To describe the ocular clinical and imaging findings of a patient with isolated vitreous metastasis, confirmed by vitreous biopsy, from an anaplastic lymphoma kinase (ALK)-positive metastatic lung cancer.Methods: Case report.Results: A 47-year-old woman with a history of metastatic ALK-positive lung cancer was referred by her oncologist because of unilateral blurred vision over 4 weeks. The fundus examination showed vitreous opacities with clumps of nonpigmented cells, without vasculitis or retinitis, whereas optical coherence tomography showed hyperreflective deposits on the inner retinal surface with no retinal involvement. Diagnostic vitrectomy revealed neoplastic cells with ALK mutation.Conclusion: This is the first report that documents a case of isolated vitreous metastasis from ALK-positive lung cancer in a patient under targeted therapy to treat metastatic lung cancer. We emphasize the importance of multimodal imaging, diagnostic vitrectomy, and a pathologist's cooperation to provide essential information about diagnosis and effective treatment.