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Choroidal metastases: case report and review

Published online by Cambridge University Press:  29 December 2020

Victor Duque Open the ORCID record for Victor Duque [Opens in a new window] ,
Carolina de la Pinta ,
Ciriaco Corral ,
Carmen Vallejo ,
Margarita Martin ,
Raul Hernanz ,
Elsa Margarita Mezherane ,
Lira Pelari ,
Antonio Hernandez  and
Mireia Valero
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Victor Duque
Affiliation:
Radiation Oncology Department, Ramon y Cajal University Hospital, Madrid, Spain
Carolina de la Pinta
Affiliation:
Radiation Oncology Department, Ramon y Cajal University Hospital, Madrid, Spain
Ciriaco Corral
Affiliation:
Ophtalmology Department, Ramon y Cajal University Hospital, Madrid, Spain
Carmen Vallejo
Affiliation:
Radiation Oncology Department, Ramon y Cajal University Hospital, Madrid, Spain
Margarita Martin
Affiliation:
Radiation Oncology Department, Ramon y Cajal University Hospital, Madrid, Spain
Raul Hernanz
Affiliation:
Radiation Oncology Department, Ramon y Cajal University Hospital, Madrid, Spain
Elsa Margarita Mezherane
Affiliation:
Radiation Oncology Department, Ramon y Cajal University Hospital, Madrid, Spain
Lira Pelari
Affiliation:
Radiation Oncology Department, Ramon y Cajal University Hospital, Madrid, Spain
Antonio Hernandez
Affiliation:
Radiation Oncology Department, Ramon y Cajal University Hospital, Madrid, Spain
Mireia Valero
Affiliation:
Radiation Oncology Department, Ramon y Cajal University Hospital, Madrid, Spain
Sonsoles Sancho
Affiliation:
Radiation Oncology Department, Ramon y Cajal University Hospital, Madrid, Spain
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Abstract

Introduction:

Choroidal metastases are the most frequent intraocular secondary tumours, with a prevalence of 2–7% according to the literature. Our aim was to review a clinical case of choroidal metastasis.

We present a case of a 63-year-old male patient diagnosed in 2018 with lung adenocarcinoma cT4N0M1. The patient had three metastases in the brain, which were successfully treated with radiosurgery (RS). The patient was treated with chemotherapy with pemetrexed–cisplatin schedule. Five months after diagnosis, the patient presented with decreased vision in the right eye. After ophthalmologic evaluation, he was diagnosed with a right choroidal metastasis, which was treated with external beam radiotherapy with 20 Gy in five fractions, resulting in improved visual acuity and a complete clinical and radiological response.

The patient took part in a clinical trial that continued with systemic chemotherapy. Twenty-two months after radiotherapy to the eye, the patient has good visual acuity without any side effects.

Conclusions:

Choroidal metastasis treated with radiotherapy achieves good local control, with limited side effects, allowing an improvement in visual acuity and consequently, an improvement in the patient´s quality of life.

Keywords

choroidal metastasisintraocular tumourradiotherapyradiation therapySBRT
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 21 , Issue 2 , June 2022 , pp. 215 - 221
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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References

Bloch, RS, Gartner, S. The incidence of ocular metastatic carcinoma. Arch Ophthalmol 1971; 85 (6): 673–675.CrossRefGoogle ScholarPubMed
Albert, DM, Rubenstein, RA, Scheie, HG. Tumor metastasis to the eye. Part I. Incidence in 213 adult patients with generalized malignancy. Am J Ophthalmol 1967; 63 (4): 723–726.CrossRefGoogle Scholar
Su, HT, Chen, YM, Perng, RP. Symptomatic ocular metastases in lung cancer. Respirology. 2008; 13 (2): 303–354.CrossRefGoogle ScholarPubMed
Greear, JN Jr. Metastatic carcinoma of the eye. Am J Ophthalmol 1950; 33 (7): 1015–1025.CrossRefGoogle ScholarPubMed
Demirci, H, Shields, CL, Chao, AN et al. Uveal metastasis from breast cancer in 264 patients. Am J Ophthalmol 2003; 136 (2): 264–271.CrossRefGoogle ScholarPubMed
Fernandes, BF, Fernandes, LH, Burnier, MN Jr. Choroidal mass as the presenting sign of small cell lung carcinoma. Can J Ophthalmol 2006; 41 (5): 605–608.CrossRefGoogle ScholarPubMed
Shields, C, Welch, R, Malik, K, et al. Uveal metastasis: clinical features and survival outcome of 2214 tumors in 1111 patients based on primary tumor origin. Middle East Afr J Ophthalmol 2018; 25 (2): 81–90.CrossRefGoogle ScholarPubMed
Shah, SU, Mashayekhi, A, Shields, CL et al. Uveal metastasis from lung cancer: clinical features, treatment, and outcome in 194 patients. Ophthalmology 2014; 121 (1): 352–357.CrossRefGoogle ScholarPubMed
Jardel, P, Sauerwein, W, Olivier, T et al. Management of choroidal metastases. Cancer Treat Rev 2014; 40 (10): 1119–1128.CrossRefGoogle ScholarPubMed
Freedman, MI, Folk, JC. Metastatic tumors to the eye and orbit: patient survival and clinical characteristics. Arch Ophthalmol 1987; 105 (9): 1215–1219.CrossRefGoogle Scholar
Konstantinidis, L, Rospond-Kubiak, I, Zeolite, I et al. Management of patients with uveal metastases at the Liverpool Ocular Oncology Centre. Br J Ophthalmol 2014; 98 (1): 92–98.CrossRefGoogle ScholarPubMed
Eliassi-Rad, B, Albert, DM, Green, WR. Frequency of ocular metastases in patients dying of cancer in eye bank populations. Br J Ophthalmol. 1996; 80 (2): 125–128.CrossRefGoogle ScholarPubMed
Salah, S, Khader, J, Yousef, Y et al. Choroidal metastases as the sole initial presentation of metastatic lung cancer: case report and review of literature. Nepal J Ophthalmol 2012; 4 (2): 339–342.CrossRefGoogle ScholarPubMed
Sobottka, B, Schlote, T, Krumpaszky, HG et al. Choroidal metastases and choroidal melanomas: comparison of ultrasonographic findings. Br J Ophthalmol 1998; 82 (2): 159–161.CrossRefGoogle ScholarPubMed
Sobottka, B, Kreissig, I. Ultrasonography of metastases and melanomas of the choroid. Curr Opin Ophthalmol 1999; 10 (3): 164–167.CrossRefGoogle ScholarPubMed
Jorge, DM, Labarrere, M, Rodrigues, MW et al. Simultaneous choroidal and retinal metastases from lung carcinoma. Retin Cases Brief Rep 2020; 14 (1): 90–95.CrossRefGoogle ScholarPubMed
Al-Dahmash, SA, Shields, CL, Kaliki, S et al. Enhanced depth imaging optical coherence tomography of choroidal metastasis in 14 eyes. Retina 2014; 34 (8): 1588–1593.CrossRefGoogle ScholarPubMed
Mathis, T, Jardel, P, Loria, O et al. New concepts in the diagnosis and management of choroidal metastases. Prog Retinal Eye Res 2019; 68: 144–176.CrossRefGoogle ScholarPubMed
Zhang, HR, Ma, ZZ, Feng, Y et al. Clinical characteristics of choroidal metastasis. Chinese J Ophthalmol 2009; 45 (4): 301–308.Google ScholarPubMed
Wiegel, T, Bottke, D, Kreusel, KM et al. External beam radiotherapy of choroidal metastases - Final results of a prospective study of the German Cancer Society (ARO 95–08). Radiother Oncol 2002; 64 (1): 13–18.CrossRefGoogle Scholar
Minatel, E, Trovo, MG, Forner, L et al. The efficacy of radiotherapy in the treatment of intraocular metastases. Br J Radiol 1993; 66 (788): 699–702.CrossRefGoogle ScholarPubMed
Ferry, AP, Font, RL. Carcinoma metastatic to the eye and orbit: I. a clinicopathologic study of 227 cases. Arch Ophthalmol 1974; 92 (4): 276–286.CrossRefGoogle Scholar
Rosset, A, Zografos, L, Coucke, P et al. Radiotherapy of choroidal metastases. Radiother Oncol 1998; 46 (3): 263–268.CrossRefGoogle ScholarPubMed
Rudoler, SB, Corn, BW, Shields, CL et al. External beam irradiation for choroid metastases: identification of factors predisposing to long-term sequelae. Int J Radiat Oncol Biol Phys 1997; 38 (2): 251–256.CrossRefGoogle ScholarPubMed
Ratanatharathorn, V, Powers, WE, Grimm, J et al. Eye metastasis from carcinoma of the breast: diagnosis, radiation treatment and results. Cancer Treat Rev 1991; 18 (4): 261–276.CrossRefGoogle ScholarPubMed
Amer, R, Pe’er, J, Chowers, I et al. Treatment options in the management of choroidal metastases. Ophthalmologica 2004; 218 (6): 372–377.CrossRefGoogle ScholarPubMed
D’Abbadie, I, Arriagada, R, Spielmann, M et al. Choroid metastases: clinical features and treatments in 123 patients. Cancer 2003; 98 (6): 1232–1238.CrossRefGoogle ScholarPubMed
Mccormick, B, Ellsworth, R, Abramson, D et al. Radiation therapy for retinoblastoma: comparison of results with lens-sparing versus lateral beam techniques. Int J Radiat Oncol Biol Phys 1988; 15 (3): 567–574.10.1016/0360-3016(88)90296-9CrossRefGoogle ScholarPubMed
Bellmann, C, Fuss, M, Holz, FG et al. Stereotactic radiation therapy for malignant choroidal tumors: preliminary, short-term results. Ophthalmolgy 2000; 107 (2): 358–365.CrossRefGoogle ScholarPubMed
Cho, KR, Lee, KM, Han, G et al. Gamma knife radiosurgery for cancer metastasized to the ocular choroid. J Korean Neurosurg Soc 2018; 61 (1): 60–65.CrossRefGoogle Scholar
Wackernagel, W, Holl, E, Tarmann, L et al. Local tumour control and eye preservation after gamma-knife radiosurgery of choroidal melanomas. Br J Ophthalmol 2014; 98 (2): 218–223.CrossRefGoogle ScholarPubMed
Shields, CL, Shields, JA, De Potter, P et al. Plaque radiotherapy for the management of uveal metastasis. Arch Ophthalmol 1997; 115 (2): 203–209 CrossRefGoogle ScholarPubMed
Lim, JI, Petrovich, Z. Radioactive plaque therapy for metastatic choroidal carcinoma. Ophthalmology 2000; 107 (10): 1927–1931.10.1016/S0161-6420(00)00252-9CrossRefGoogle ScholarPubMed
Sas-Korczyńska, B, Dixon, BR, Skołyszewski, J et al. Choroidal metastases of malignancies. Review of treatment methods with special regard to application of radiotherapy. Klin Oczna 2006; 108 (7–9): 346–352.Google ScholarPubMed
Kamran, SC, Collier, JM, Lane, AM et al. Outcomes of proton therapy for the treatment of uveal metastases. Int J Radiat Oncol Biol Phys 2014; 90 (5): 1044–1050.CrossRefGoogle ScholarPubMed
Tsina, EK, Lane, AM, Zacks, DN et al. Treatment of metastatic tumors of the choroid with proton beam irradiation. Ophthalmology 2005; 112 (2): 337–343.CrossRefGoogle ScholarPubMed
Yasui, H, Sato, K, Takeyama, Y et al. Effective treatment with intravitreal injection of bevacizumab for exudative retinal detachment secondary to choroidal metastasis of non-small cell lung carcinoma. Am J Case Rep 2015; 16: 728–732.CrossRefGoogle ScholarPubMed
Shields, CL, Khoo, CTL, Mazloumi, M et al. Photodynamic therapy for choroidal metastasis tumor control and visual outcomes in 58 cases: the 2019 burnier international ocular pathology society lecture. Ophthalmology Retina 2020; 4 (3): 310–319.CrossRefGoogle ScholarPubMed
Kaliki, S, Shields, CL, Al-Dahmash, SA et al. Photodynamic therapy for choroidal metastasis in 8 cases. Ophthalmology 2012; 119 (6): 1218–1222.CrossRefGoogle ScholarPubMed
Ghodasra, DH, Demirci, H. Photodynamic therapy for choroidal metastasis. Am J Ophthalmol 2016; 161: 104–9.e1–2.CrossRefGoogle ScholarPubMed
Hua, R, Li, W, Wu, W et al. Failure of ocular photodynamic therapy for secondary choroidal metastasis: a case report and literature review. Oncotarget 2017; 8 (55): 95030–95035.CrossRefGoogle ScholarPubMed