title: Tyrosine Kinase Inhibitors in the Treatment of Choroidal Metastases from Non-Small-Cell Lung Cancer: A Case Report and Review of Literature.
abstract: BACKGROUND
  Choroidal metastases being the sole presenting feature of lung cancer is rare. Erlotinib, a tyrosine kinase inhibitor (TKI), is used in the treatment of lung adenocarcinoma where tumor cells exhibit epidermal growth factor receptor (EGFR) mutations. We report a case of metastatic non-small-cell lung cancer (NSCLC) with choroidal metastasis, which was the sole presenting feature and which responded to erlotinib.
  
  
  METHODS
  We performed a retrospective case review.
  
  
  METHODS
  A 78-year-old man presented with a choroidal mass which was found to be the presenting feature of metastatic NSCLC. Our patient, a nonsmoker, had disseminated bony metastases, and therefore was advised to undergo palliative chemotherapy, which he refused. He was therefore instituted on oral erlotinib.
  
  
  RESULTS
  Tumor cells expressing EGFR mutations are known to be susceptible to TKIs. Even though the tumor in our case showed no mutation, i.e. was classified as 'wild-type', our patient showed a dramatic response to erlotinib. At 1 year, the choroidal lesion had regressed and visual acuity had recovered.
  
  
  CONCLUSIONS
  TKIs may be beneficial in patients with choroidal metastases from NSCLC, especially those in which an EGFR mutation is noted. Even in the absence of such mutations, choroidal metastases may show a favorable effect in response to TKIs, such as erlotinib.
authors.affiliation: Advanced Eye Hospital and Institute, Mumbai, India; Aditya Jyot Eye Hospital, Mumbai, India; Mehta Eye Clinic Pvt. Ltd, Mumbai, India; Lokmanya Tilak Municipal Medical College and Hospital, Mumbai, India.
authors.forename: Akshay Gopinathan
authors.initials: AG
authors.lastname: Nair
authors.affiliation: Advanced Eye Hospital and Institute, Mumbai, India; Mehta Eye Clinic Pvt. Ltd, Mumbai, India.
authors.forename: Haresh T
authors.initials: HT
authors.lastname: Asnani
authors.affiliation: Mehta Eye Clinic Pvt. Ltd, Mumbai, India.
authors.forename: Vinod C
authors.initials: VC
authors.lastname: Mehta
authors.affiliation: Mehta Eye Clinic Pvt. Ltd, Mumbai, India.
authors.forename: Siddharth V
authors.initials: SV
authors.lastname: Mehta
authors.affiliation: Tata Memorial Cancer Hospital, Mumbai, India; British Columbia Cancer Agency, Abbotsford, B.C., Canada.
authors.forename: Rima S
authors.initials: RS
authors.lastname: Pathak
authors.affiliation: Lokmanya Tilak Municipal Medical College and Hospital, Mumbai, India.
authors.forename: Amit H
authors.initials: AH
authors.lastname: Palkar
authors.affiliation: Clinico-Path Labs, Mumbai, India.
authors.forename: Indumati
authors.initials: I
authors.lastname: Gopinathan
keywords: Choroidal; Epidermal growth factor receptor; Erlotinib; Lung cancer; Metastases; Non-small-cell lung cancer; Targeted therapy; Tyrosine kinase inhibitors