Ocular metastasis of lung adenocarcinoma with ELM4-ALK translocation: A case report with a review of the literature

Jiang, Kailun; Brownstein, Seymour; Sekhon, Harmanjatinder S.; Laurie, Scott A.; Lam, Kay; Gilberg, Steven; Britton, William A.

doi:10.1016/j.sjopt.2013.06.011

Cited by 14 publications

(9 citation statements)

References 33 publications

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“…To date only three ALK-rearranged NSCLC patients with choroidal metastasis have been reported in the literature. Jiang et al reported a patient who presented with choroidal metastasis in the left eye as the initial symptoms of NSCLC [11]. The patient was eventually treated with enucleation before the diagnosis of ALK rearranged was made.…”

Section: Discussionmentioning

confidence: 99%

Choroidal metastasis response to crizotinib in a ROS1-rearranged NSCLC patient

Song-nian

Azada

2015

Lung Cancer

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Section: Discussionmentioning

confidence: 99%

Choroidal metastasis response to crizotinib in a ROS1-rearranged NSCLC patient

Song-nian

Azada

2015

Lung Cancer

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“…At the time of ocular diagnosis, 34% have an unknown primary, 47% to 81% are from breast primaries, and 9% to 23% are from lung primaries. [ 1 ]…”

Section: Discussionmentioning

confidence: 99%

Alectinib in the treatment of ocular metastases of ALK rearranged non small cell lung cancer

et al. 2020

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Rationale: Choroidal metastasis is a rare metastatic location although the most common intraocular neoplasm. In general, choroidal metastases respond favorably to systemic therapy targeted toward the primary neoplasm. In patients with choroidal metastasis of ALK rearranged non small cell lung cancer (NSCLC), targeted therapy using Alk inhibitors gradually replaced radiotherapy as the best treatment. Alectinib is a second-generation ALK inhibitors. Here we describe 2 clinical cases of patients with choroidal metastasis of ALK rearranged NSCLC who received Alectinib as first-line therapy achieving disease control and quality of life improvement. Patients concerns: In case report 1, 62-year-old man presented with scintillated scotomas at the level of the right eye; in case report 2, 69-year-old man presented with respiratory distress, persistent cough resistant to medical therapy, pain, and blurred vision. Diagnoses: In case report 1, fundus and ultrasonographic examination showed circumscribed choroid thickening with dome-like appearance compatible with repetitive lesion. Computed tomographic/y (CT) showed multiple bilateral pulmonary nodular formations and adenocarcinoma of the lung was diagnosed by a transbronchial biopsy. In case report 2, CT showed a primary lesion of 36 × 27 mm in the middle lobe with bilateral lung metastases and lymphadenopathies. Multiple hepatic metastases and minor suspicious bone repetitions. A liver biopsy made a diagnosis of adenocarcinoma compatible with pulmonary primitiveness. An ocular fluoroangiography evidenced a left choroidal metastasis. Interventions: Case report 1, 2, medical treatment with Alectinib 1200 mg/day was initiated. Outcomes: In case report 1, a few days after beginning the treatment, both systemic symptoms like respiratory distress and low vision were palliated. Reassessment by CT confirmed treatment response. In case report 2, clinically, visus disorders had already improved 2 weeks after beginning treatment. CT showed pulmonary, nodal, and hepatic response. Stability of bone metastases occurred after 2 months. In addition, ocular ultrasonography documented the regression of previously reported lesions confirmed treatment response. Lessons: Alectinib works very well in intracranial metastases and is assumed to be so on the ocular ones as well, with benefit for the patient in quality of life.

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“…They are crizotinib, a first generation ALK inhibitor ( 10 ), and alectinib ( 12 ) and ceritinib ( 13 ), which are second generation inhibitors. There have been five case reports of patients with choroidal metastasis of ALK-rearranged NSCLC ( 14 - 18 ). These four case reports were based on crizotinib therapy, and one case report was based on alectinib therapy for a crizotinib-resistant patient.…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment with Alectinib for Choroidal Metastasis in Anaplastic Lymphoma Kinase Rearranged Non-small Cell Lung Cancer

et al. 2017

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Abstract:Choroidal metastasis is rare in cancer patients and it may cause visual disturbances that reduce their quality of life. In non-small cell lung cancer (NSCLC), targeted therapy against actionable driver mutations has gradually replaced radiotherapy as the treatment of choice for choroidal metastasis. Recently, there have been several case reports of choroidal metastasis in patients with anaplastic lymphoma kinase (ALK)-rearranged NSCLC. We herein report the case of a 40-year-old Japanese woman diagnosed with choroidal metastasis of an ALK-rearranged NSCLC who received alectinib as the first-line chemotherapy. Alectinib may be the best treatment for choroidal metastasis in patients harboring an ALK translocation because of its favorable side effect profile involving visual disturbances.

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Ocular metastasis of lung adenocarcinoma with ELM4-ALK translocation: A case report with a review of the literature

Cited by 14 publications

References 33 publications

Choroidal metastasis response to crizotinib in a ROS1-rearranged NSCLC patient

Choroidal metastasis response to crizotinib in a ROS1-rearranged NSCLC patient

Alectinib in the treatment of ocular metastases of ALK rearranged non small cell lung cancer

Successful Treatment with Alectinib for Choroidal Metastasis in Anaplastic Lymphoma Kinase Rearranged Non-small Cell Lung Cancer

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