Simultaneous Retinal and Iris Metastases in Small Cell Lung Carcinoma

Abstract

Purpose: The aim of this study is to present the case of a 60-year-old male with a rare presentation of small cell lung carcinoma (SCLC) metastases to the retina and iris.Methods: The patient's history and ophthalmic examinations, including best corrected visual acuity, intraocular pressure, slit-lamp biomicroscopy, fundoscopy, spectral-domain optical coherence tomography (SD-OCT), fluorescein angiography, and histopathology, are described. Results:A 60-year-old male was diagnosed with SCLC, with a TNM classification of TxN3M1b. On ophthalmic examination, a greyish-white gelatinous iris mass in the right eye and an ill-defined yellow-white retinal lesion with intrinsic hemorrhages in the left eye were found. SD-OCT through the retinal lesion revealed thickening of the retina and inner retinal replacement by tumor. No apparent involvement of the underlying choroid was noted. Fluorescein angiography revealed a hyperfluorescent mass with intrinsic vascularity in the left eye and the hyperfluorescence increased during the late phase. Excisional biopsy and immunohistochemistry of the iris mass showed the tumor cells were consistent with a metastatic small cell carcinoma. Conclusion:In all ocular metastases, uveal metastasis is the most common form. Metastases to the retina, optic disc, and vitreous are rare. We report an unusual case of a patient with SCLC presented with simultaneous retina and iris metastases in the both eyes. The SD-OCT features of the retinal metastasis from SCLC are presented for the first time.