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Choroidal metastases as presenting manifestation of lung squamous cell carcinoma
*For correspondence: drreemab@rediffmail.com
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This article was originally published by Wolters Kluwer - Medknow and was migrated to Scientific Scholar after the change of Publisher.
A 61 yr old male† (chronic smoker) presented at the Advanced Eye Centre, Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh, India in June 2019, with visual loss in the right eye with a large choroidal mass, obscuring optic disc (Figure A). Contrast-enhanced computed tomography (chest and abdomen) (Figure B) showed nodular pleural thickening, pleural fluid suggestive of lung carcinoma, with non-enhancing lesions in the liver, suggestive of metastasis. Fine needle aspiration cytology (ultrasound-guided) from the liver (Figure C) showed squamous cell clusters, pleomorphic nuclei, coarse chromatin, inconspicuous nucleoli and moderate-to-abundant cytoplasm, confirming metastatic squamous cell carcinoma. The patient was advised therapy but did not follow up. Visual loss as the primary symptom of lung cancer is rare, and ocular metastasis from lung carcinoma occurs in 2-7 per cent patients. This case highlights the significance of systemic evaluation and imaging in a patient with visual loss and choroidal involvement with no obvious systemic complaints.
- (A) Right eye fundus photograph showing a large choroidal mass. (B) Contrast-enhanced computed tomography (chest and abdomen) showing nodular pleural thickening (yellow arrow), pleural fluid (red arrow) suggestive of lung carcinoma and non-enhancing lesions in the liver (black arrow) suggestive of metastasis. (C) Ultrasound-guided fine needle aspiration cytology (liver) (H and E, ×20) showing squamous cell clusters (arrow), pleomorphic nuclei, coarse chromatin, inconspicuous nucleoli and moderate-to-abundant cytoplasm, confirming metastatic squamous cell carcinoma.
Conflicts of Interest: None.
