Incidence and clinical characteristics of symptomatic choroidal metastasis from lung cancer.
OBJECTIVE
To determine the clinical characteristics of symptomatic choroidal metastasis (CM) resulting from metastatic lung cancer.


METHODS
Twenty-two consecutive patients with symptomatic CM resulting from lung cancer were retrospectively reviewed for ocular findings, medical history and systemic disease. All patients underwent a complete screening for further organ metastasis by computed tomography (CT) and bone scintigraphy. Annual frequency of CM was determined and compared with the incidence predicted from ocular screening studies.


RESULTS
In eight of 22 (36%; 95% confidence interval [CI] 17-59) patients, lung cancer had been diagnosed before occurrence of CM, with a median interval of 13 months. In 14 patients lung cancer was detected after diagnosis of CM, with a median interval of 1 month. Choroidal metastasis was unilateral, solitary and located close to or at the posterior pole in the majority of patients. Further organ metastasis with a median number of three affected organ systems was present in 19 (86%; 95% CI 65-97) patients. Median survival after diagnosis of symptomatic CM was 13 months, by contrast with 2 months in lung cancer patients with CM identified in an ocular screening study. The mean number of patients in Berlin diagnosed with symptomatic CM was 1.4 per year, which was two orders of magnitude less than predicted from screening studies.


CONCLUSIONS
Symptomatic choroidal lung cancer metastasis in the majority of patients presents as a solitary tumour before diagnosis of lung cancer in patients with multiple organ systems affected by metastatic disease. Contrary to predictions from ocular screening studies, it is a rare clinical entity.
Kreusel
Klaus-Martin
KM
Eye Centre, German Red Cross Clinic, Westend, Berlin, Germany. kmkreusel@aol.com
Bechrakis
Nikolaos E
NE
Wiegel
Thomas
T
Krause
Lothar
L
Foerster
Michael H
MH
D000230:Adenocarcinoma / Q000175:diagnosis / Q000453:epidemiology / Q000556:secondary; D000328:Adult; D000368:Aged; D002276:Carcinoid Tumor / Q000175:diagnosis / Q000453:epidemiology / Q000556:secondary; D018287:Carcinoma, Large Cell / Q000175:diagnosis / Q000453:epidemiology / Q000556:secondary; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000453:epidemiology / Q000556:secondary; D002830:Choroid Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000556:secondary*; D005260:Female; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000453:epidemiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D055752:Small Cell Lung Carcinoma / Q000175:diagnosis / Q000453:epidemiology / Q000556:secondary; D014057:Tomography, X-Ray Computed