Uveal metastasis: Clinical features and survival outcome of 2214 tumors in 1111 patients based on primary tumor origin

Abstract

PURPOSE:The purpose of this study is to evaluate patients with uveal metastasis based on primary tumor site.METHODS:Retrospective analysis from Wills Eye Hospital, Philadelphia, PA, USA, for uveal metastasis clinical features and outcomes based on the primary tumor site.RESULTS:There were 2214 uveal metastases diagnosed in 1111 consecutive patients. The demographics included mean age of 60 years (median 61 years), Caucasian race (88%), and female gender (64%). The tumor was unilateral (82%) and primary site was established before uveal metastasis (67%). The primary tumor originated in the breast (37%), lung (26%), kidney (4%), gastrointestinal (GI) tract (4%), cutaneous melanoma (2%), lung carcinoid (2%), prostate (2%), thyroid (1%), pancreas (1%), other sites (3%), and unknown (16%). Comparative analysis of the 5 most common primary sites (breast, lung, kidney, GI tract, and cutaneous melanoma), revealed metastasis at mean age (57, 62, 66, 61, 59 years), as unilateral tumor (74%, 86%, 85%, 93%, 85%), with mean number of metastasis/eye (1.9, 1.7, 1.0, 1.1, 2.0), and in females (99%, 46%, 26%, 25%, 30%). Choroidal metastases measured mean base (9.3, 10.2, 9.1, 11.0, 7.3 mm), mean thickness (2.4, 3.6, 4.4, 4.0, 2.9 mm), and demonstrated predominant color yellow (94%, 91%, 56%, 97%, 36%). Of the 769 patients with documented follow-up, mean patient survival was poor (22.2, 11.5, 8.6, 12.4, 11.4 months) and Kaplan–Meier analysis revealed 3-year survival (33%, 19%, 0%, 14%, 21%) and 5-year survival (24%, 13%, 0%, 14%, 21%). The worst survival was found in patients with pancreatic metastasis (mean 4.2 months) and best survival with lung carcinoid (92% at 5 years).CONCLUSION:In a tertiary referral service, uveal metastasis originates from cancer in the breast, lung, kidney, GI tract, cutaneous melanoma, or others. Overall prognosis is poor with 5-year survival at 23% and worst survival with pancreatic metastasis whereas best survival with lung carcinoid metastasis.

Chondrosarcoma Metastasis to the Choroid

“…Although metastatic disease is the most common cause of choroidal tumors [7, 8], bone sarcoma metastasis to the choroid is exceedingly rare. To our knowledge, there have been 9 published cases of intraocular metastases from bone sarcoma [5, 6, 8-14], only 2 of which were from chondrosarcoma [5, 6].…”

“…To our knowledge, there have been 9 published cases of intraocular metastases from bone sarcoma [5, 6, 8-14], only 2 of which were from chondrosarcoma [5, 6]. In 1996, George and Zamber [5] described the first case of chondrosarcoma metastatic to the eye.…”

An Unusual Case of “Red Eye”

“…Our patientʼs death occurred only 1 month after initial presentation, which is less than what has been reported to be the mean survival time. Shields et al presented a 5year survival rate of 24 % and a mean survival of 22.2 months in cases with uveal metastases due to breast cancer being the primary tumor site [8].…”

Photodynamic Therapy of Presumed Choroidal Metastasis Secondary to Colorectal Carcinoma: Literature Review

“…The incidence of metastasis of CRC to the choroid and retina is not yet clear, even though a survey by Shields determined that 4% of all uveal metastases (43 eyes of 40 patients) are caused by tumors of the gastrointestinal tract in a survey of 2214 tumors in 1111 patients [8]. In 2014, Tei et al [31] published one case of choroidal metastasis secondary to rectum carcinoma plus a review of thirteen case reports of the literature with a discussion about ophthalmic and systemic features.…”

“…Ocular and periocular metastases in patients with CRC have been described in the medical literature, with the choroid being the main site [4][5][6][7][8]. Choroidal metastasis may be uni-or bilateral and may comprise around 4% of CRC sites of metastasis [8,9]. Management of such choroidal lesions may be challenging, since there is no consensus about treatment.…”