Choroidal metastasis from carcinoma of the bladder.
OBJECTIVE
To report choroidal metastasis from the newly described nested variant of urothelial carcinoma of the bladder as the initial presentation of metastatic disease.


METHODS
A 58-year-old man with a history of urothelial bladder carcinoma developed progressive decreased visual acuity in the right eye. Fundus examination showed an amelanotic choroidal tumor simulating a choroidal melanoma. Results of ancillary diagnostic tests, needle aspiration biopsy, and systemic workup failed to confirm the diagnosis of choroidal metastasis. The patient was treated with enucleation the affected right eye.


RESULTS
Histopathologic analysis of the enucleated eye disclosed a choroidal metastatic carcinoma with urothelial features similar to those of the bladder carcinoma excised previously. Despite adjuvant systemic chemotherapy, the patient died 7 months after enucleation.


CONCLUSIONS
Choroidal metastasis may be the initial manifestation of metastatic bladder carcinoma and is associated with a poor survival prognosis.
From the *Ocular Oncology Unit and the †Pathology Laboratory, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium.
Laurent
L
Levecq
Patrick
P
De Potter
Catherine
C
Godfraind
Ann-Pascal E
AP
Guagnini
Alexandra
A
Kozyreff