A Comprehensive Understanding of Choroidal Metastasis from Lung Cancer

Abstract

The incidence of lung cancer with intraocular metastasis is low, of which choroidal metastasis is the most painful metastatic lesion. The clinical symptoms resulting from choroidal metastasis from lung cancer easily detected although they are rarely identified prior to the diagnosis of the primary malignancy. The quality of life of patients is inevitably impaired. Some lung cancer patients complain of ocular symptoms as the first manifestation of lung cancer. Early diagnosis and treatment can significantly overcome or delay the visual impairment and improve prognosis. The main therapeutic modalities include systemic and local treatments, while observation is also a treatment option. Currently, the feasibility and effectiveness of various treatment options are controversial worldwide. Herein, we summarize the underlying mechanisms, epidemiology, clinical features, auxiliary examinations, diagnosis, and recent treatment options for intraocular metastases.

Exploring the FGF/FGFR System in Ocular Tumors: New Insights and Perspectives

“…The eye may represent the site of metastasis for several tumors, in particular breast (47%) and lung (21%) cancers, but also of cutaneous melanoma, tumors of the gastrointestinal tract, and kidney cancer [ 5 , 7 ]. Metastasis might arise in any part of the eyeball or the orbit, but 88% of cases affect the posterior uvea due to its extensive vascularization [ 7 , 29 ]. Therapeutic strategies include systemic therapies, local treatment, or a combination of both [ 29 ].…”

“…Metastasis might arise in any part of the eyeball or the orbit, but 88% of cases affect the posterior uvea due to its extensive vascularization [ 7 , 29 ]. Therapeutic strategies include systemic therapies, local treatment, or a combination of both [ 29 ]. Radiotherapy, either with external beam radiation or brachytherapy, is the most common treatment for metastatic disease [ 30 ].…”

Choroidal Metastasis Revealing a Lung Adenocarcinoma: A Case Report

“…The incidence of intraocular metastases is about 8-10% [ 2 ]. After breast cancer, lung tumors are the second most important origin of CM representing 20 to 29 % of cases [ 3 ].…”

“…The treatment of choroidal metastasis depends on the systemic status, number of choroidal tumors, location, and laterality. Ocular radiotherapy is considered a standard treatment option for intraocular metastatic tumors [ 2 ]. Systemic chemotherapy, immunotherapy, hormone therapy, or whole eye radiotherapy are performed if the metastases are multifocal and bilateral.…”

Delayed Diagnosis of Lung Carcinoma Presenting as Choroidal Metastasis in a COVID-19 Patient and Initially Treated with Osimertinib

“…The arrival of systemic targeted therapies represents a more important and lasting game-changer, as they have improved life expectancy significantly in cancer patients who harbor the target mutation 1 , 3 , and specifically in lung cancer patients with EGFR (epidermal growth factor receptor) mutations 4 , 5 , 6 . However, for CM patients, this better prognosis implies that long-term radiation-induced side effects, in particular secondary ischemic retinopathy or optic neuropathy, become an increasing challenge.…”