Abstract
Purpose
Choroidal metastasis from lung cancer is very rare in the clinical setting. Treatment for lung cancer with symptomatic choroidal metastasis remains uncertain because of the rarity of such cases.
Methods
We performed a retrospective study on symptomatic choroidal metastasis from lung cancer at the Kaohsiung Medical University Hospital from January 2010 to August 2011. In addition, we also performed literature review of all such patients (or of cancers with choroidal metastasis) treated with systemic chemotherapy.
Results
In our study, a total of 226 lung cancer patients were registered during the study period, and only four had choroidal metastasis (4/226, 1.77 %). Three were female (75 %) and one was male, with a mean age of 40.74 (range 26–60) years. Three patients had marked choroidal tumor regression after treatment with pemetrexed and cisplatin. In the literature reviews, there are only 12 patients (including our patients) received systemic chemotherapy alone instead of local therapy and eight (66.7 %) demonstrated choroidal tumor regression after treatment.
Conclusions
Symptomatic choroidal metastasis from lung cancer is extremely rare. Our findings indicate that systemic chemotherapy with pemetrexed and cisplatin may be a good option for such patients. Further large-scale studies for the treatment of such patients are warranted. However, currently, radiotherapy is still the gold standard for such patients.
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References
Postmus PE, Brambilla E, Chansky K et al (2007) The IASLC lung cancer staging project: proposals for revision of the M descriptors in the forthcoming (seventh) edition of the TNM classification of lung cancer. J Thorac Oncol 2:686–693
Kreusel KM, Bechrakis NE, Wiegel T et al (2008) Incidence and clinical characteristics of symptomatic choroidal metastasis from lung cancer. Acta Ophthalmol 86:515–519
Herrag M, Lahmiti S, Yazidi AA et al (2010) Choroidal metastasis revealing a lung adenocarcinoma. Ann Thorac Surg 89:1013–1014
John VJ, Jacobson MS, Grossniklaus HE (2010) Bilateral choroidal metastasis as the presenting sign of small cell lung carcinoma. J Thorac Oncol 5:1289
Kim SW, Kim MJ, Huh K et al (2009) Complete regression of choroidal metastasis secondary to non-small-cell lung cancer with intravitreal bevacizumab and oral erlotinib combination therapy. Ophthalmologica 223:411–413
Singh A, Singh P, Sahni K et al (2010) Non-small cell lung cancer presenting with choroidal metastasis as first sign and showing good response to chemotherapy alone: a case report. J Med Case Rep 4:185
Okuma Y, Hosomi Y, Kitamura K et al (2009) Choroidal metastasis in a patient with small cell lung cancer discovered during treatment with chemotherapy. Int J Clin Oncol 14:541–544
Chen CJ, McCoy AN, Brahmer J et al (2011) Emerging treatments for choroidal metastases. Surv Ophthalmol 56:511–521
Amer R, Pe’er J, Chowers I et al (2004) Treatment options in the management of choroidal metastases. Ophthalmologica 218:372–377
Rosset A, Zografos L, Coucke P et al (1998) Radiotherapy of choroidal metastases. Radiother Oncol 46:263–268
Mauget-Faysse M, Gambrelle J, Quaranta-El MM et al (2006) Photodynamic therapy for choroidal metastasis from lung adenocarcinoma. Acta Ophthalmol Scand 84:552–554
Wiegel T, Bottke D, Kreusel KM et al (2002) External beam radiotherapy of choroidal metastases–final results of a prospective study of the German Cancer Society (ARO 95-08). Radiother Oncol 64:13–18
Asteriou C, Konstantinou D, Kleontas A et al (2010) Blurred vision due to choroidal metastasis as the first manifestation of lung cancer: a case report. World J Surg Oncol 8:2
Inoue M, Watanabe Y, Yamane S et al (2010) Choroidal metastasis with adenocarcinoma of the lung treated with gefitinib. Eur J Ophthalmol 20:963–965
Singh N, Kulkarni P, Aggarwal AN et al (2012) Choroidal metastasis as a presenting manifestation of lung cancer: a report of 3 cases and systematic review of the literature. Medicine (Baltimore) 91:179–194
George B, Wirostko WJ, Connor TB et al (2009) Complete and durable response of choroid metastasis from non-small cell lung cancer with systemic bevacizumab and chemotherapy. J Thorac Oncol 4:661–662
Harino S, Miyamoto K, Okada M et al (1995) Indocyanine green videoangiographic findings in choroidal metastatic tumor. Graefes Arch Clin Exp Ophthalmol 233:339–346
Hasturk S, Soylu M, Zeren EH et al (2001) Basaloid large cell lung carcinoma presenting concurrently with metastatic uveal tumor. Lung Cancer 32:95–101
Ascaso FJ, Castillo JM, Garcia FJ et al (2009) Bilateral choroidal metastases revealing an advanced non-small cell lung cancer. Ann Thorac Surg 88:1013–1015
Shields JA, Perez N, Shields CL et al (2002) Simultaneous choroidal and brain metastasis as initial manifestations of lung cancer. Ophthalmic Surg Lasers 33:323–325
Fujiu K, Kobayashi N, Miyamoto H et al (2012) A case of choroidal metastasis of lung cancer successfully treated with erlotinib. Gan To Kagaku Ryoho 39:269–271
De PP (1998) Ocular manifestations of cancer. Curr Opin Ophthalmol 9:100–104
Freedman MI, Folk JC (1987) Metastatic tumors to the eye and orbit. Patient survival and clinical characteristics. Arch Ophthalmol 105:1215–1219
Kanthan GL, Jayamohan J, Yip D et al (2007) Management of metastatic carcinoma of the uveal tract: an evidence-based analysis. Clin Experiment Ophthalmol 35:553–565
Wang TJ, Yang CM, Ho TC et al (2005) Metastatic choroidal tumors in Taiwan: an 11-year experience. Am J Ophthalmol 140:735–737
Kreusel KM, Wiegel T, Stange M et al (2002) Choroidal metastasis in disseminated lung cancer: frequency and risk factors. Am J Ophthalmol 134:445–447
Shields JA, Shields CL, Eagle RC et al (2004) Lung cancer presenting as vitreous hemorrhage from choroidal metastasis. Retina 24:168–170
Abundo RE, Orenic CJ, Anderson SF et al (1997) Choroidal metastases resulting from carcinoma of the lung. J Am Optom Assoc 68:95–108
Arevalo JF, Fernandez CF, Garcia RA (2005) Optical coherence tomography characteristics of choroidal metastasis. Ophthalmology 112:1612–1619
Chong JT, Mick A (2005) Choroidal metastasis: case reports and review of the literature. Optometry 76:293–301
Kiratli H, Kiratli PO, Ercan MT (1998) Scintigraphic evaluation of tumors metastatic to the choroid using technetium-99 m(V)-dimercaptosuccinic acid. Jpn J Ophthalmol 42:60–65
Scagliotti GV, Parikh P, von Pawel J et al (2008) Phase III study comparing cisplatin plus gemcitabine with cisplatin plus pemetrexed in chemotherapy-naive patients with advanced-stage non-small-cell lung cancer. J Clin Oncol 26:3543–3551
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Chih-Jen Yang and Ying-Ming Tsai have contributed equally to this article.
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Yang, CJ., Tsai, YM., Tsai, MJ. et al. The effect of chemotherapy with cisplatin and pemetrexed for choroidal metastasis of non-squamous cell carcinoma. Cancer Chemother Pharmacol 73, 199–205 (2014). https://doi.org/10.1007/s00280-013-2341-4
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DOI: https://doi.org/10.1007/s00280-013-2341-4