Metastatic choriocarcinoma to the choroid with concurrent optic nerve involvement: a case report and review of the literature.
OBJECTIVE
To describe a case of choroidal metastasis of choriocarcinoma, which presented as a rapidly progressive hemorrhagic retinal detachment with concurrent optic nerve involvement suggestive of inflammation or metastasis.


METHODS
This is a case report of a 43-year-old patient with a known history of choriocarcinoma metastases to both lungs who presented with 1 week of right eye pain and decreased vision. Dilated fundus examination was significant for a large, bullous, hemorrhagic retinal detachment, with the appearance of an underlying choroidal mass in the superonasal retina. Magnetic resonance imaging result was significant for a 1.6 × 1.3-cm heterogeneous mass in the right globe, suggestive of metastasis, and inflammatory changes in the sclera, optic nerve, and optic nerve sheath. Additionally, hemorrhagic metastases were found in the right occipital and left frontal lobes.


RESULTS
To our knowledge, this is the first case of metastatic choriocarcinoma to the choroid with concurrent optic nerve involvement.


CONCLUSIONS
Choroidal metastases may be diagnosed in the setting of more widespread central nervous system involvement and should be investigated accordingly.
Department of Ophthalmology, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts.
Christine N
CN
Pham Lagler
Donna E
DE
Siracuse-Lee