Uveal metastasis has been shown to be the most common form of intraocular malignancy. Over 85% of metastatic uveal neoplasms are choroidal. Most of these metastases to the eye are carcinomas, originating mostly from breast and lungs cancers, although primary neoplasms from several other tissues have been reported. Carcinoid metastatic to the choroid is rare; it is reported to comprise slightly more than 2% of uveal metastases. The following is the presentation of a case of carcinoid metastatic to the choroid and its response to our treatment.
A 65-year-old woman presented complaining of 6 weeks of “seeing blobs of silver light” in her left eye lasting 2-3 seconds per episode. The patient’s ocular history was significant for moderate myopia. Her medical history was remarkable for carcinoid metastatic to her liver and pancreas, as well as hypercholesterolemia and high blood pressure.
The patient’s carcinoid tumor presented as a cough over six years ago, and was definitively diagnosed by bronchial biopsy with histopathology one year after presentation. Systemic work-up at that time was negative; the patient had no symptoms of carcinoid syndrome and had a laboratory profile, including a 5-HIAA level, within normal limits. An MRI of the brain was normal. The bronchial carcinoid was treated with short-term chemotherapy followed by radiation therapy to the primary lesion with a good response following 50.4 Gy of radiation therapy. The patient eventually developed metastases to both her liver and pancreas. Her carcinoid is followed by her oncologist and treated with sandostatin 20mg once a month.