[Ciliary body metastasis as the first sign of small-cell bronchial carcinoma].
BACKGROUND
About 3-10% of patients suffering from metastatic disease develop metastatic choroidal tumors. In this case report ocular symptoms were the first sign of a systemic malignancy.


METHODS
A 65-year old man complained of an increasing painful redness of his left eye. He showed a white mass with 10 mm in thickness in the temporal chamber angle with "pseudohypopyon" and secondary glaucoma. Because of increasing pain the eye was removed. Histologic examination showed a small cell carcinoma of the ciliary body with high malignancy, which most probably has to be seen as a metastasis of a carcinoma of the lung, which was detected by internal examination concurrently. In addition, a metastasis in the adrenal gland was found. ACE polychemotherapy was performed, but 4 months later the patient died of metastatic disease with break down of the kidneys.


CONCLUSIONS
Based on literature data patients with systemic malignancy present themselves to a physician primarily because of ocular symptoms in 12-31%. In these cases differentiation of an uveal metastasis from a primary amelanotic melanoma can be difficult. The search for primary tumors has to be started in due time.
Stoffelns
B M
BM
Augenklinik der Johannes Gutenberg-Universität, Mainz. stoffelns@augen.klinik.uni-mainz.de
Dick
B
B
D000310:Adrenal Gland Neoplasms / Q000556:secondary; D000368:Aged; D002283:Carcinoma, Bronchogenic / Q000175:diagnosis*; D018288:Carcinoma, Small Cell / Q000175:diagnosis* / Q000556:secondary*; D002830:Choroid Neoplasms / Q000175:diagnosis* / Q000556:secondary; D002924:Ciliary Body / Q000473:pathology*; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000556:secondary
Ziliarkörpermetastase als Ersthinweis auf ein kleinzelliges Bronchialkarzinom.