Cases of choroidal metastasis revealing lung cancer

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Abstract

Purpose

Choroidal metastases are the most common intraocular malignant tumor but rarely reveal cancer. However the role of the ophthalmologist is central to diagnose this disease. Ophthalmological examination, optical coherence tomography, ultrasound and angiography may help for differentiate metastasis to other choroidal tumors. The aim to this presentation is to describe to identical cases of choroidal metastasis revealing lung cancer.

Methods

We report 2 cases, a 53-year-old woman and a 63-year-old man, with no prior history of neoplasia who consulted for decreased visual acuity of the right eye. In both, eye fundus examination reveals a suspicious yellowish choroidal lesion. Fundus examination, optical coherence tomography (confirming the serous retinal detachment), ultrasound (confirming the plan or thick appearance) and angiography (showing blocking defect in early stage and hyperfluorescence with pin points in late stage for fluorescein angiography and diffuse hypofluorescence in late stage for indocyanin angiography) led us to the conclusion of choroidal metastasis. Then, next investigations were mammography (for woman) and body scan (for both). The results reveal an adenocarcinoma of the lung for both cases.

Conclusion

Choroidal metastases are rarely inaugural of a cancer but an early diagnosis is essential. The role of ophthalmologist is central to the diagnosis and both cases allow remembering the main diagnostic criteria.

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