Juxtapapillary Tumor as Lung Cancer’s First Manifestation

Abstract

Introduction: Metastatic carcinoma is the most prevalent intraocular neoplasm among adults. Usually, the ophthalmologist is the first physician detecting the spread of neoplasia, which in this case occurred as the first manifestation of lung cancer. Delayed diagnosis of this type of cancer leads to low rate survival over 5 years. Juxtapapillary ocular metastasis is a very rare lung cancer presentation, even rarer as the first manifestation of primary neoplasm. The aim of this report is to describe the occurrence of a juxtapapillary intraocular tumor as lung cancer’s first sign. Case report: Sixty-six years old female presents with complaints of visual impairment to an ophthalmologist, which detects intraocular tumor in the left eye. Retinography, fundus autofluorescence, fluorescein angiography, optical coherence tomography and ultras sonography were used to characterize tumor, which appeared in an unusual way: juxtapapillary. Clinical investigation was performed, the primary lesion was found in the lung and biopsy accused the adenocarcinoma type. Tumor regressed after chemotherapy, improving visual acuity. Discussion: The intraocular tumor presentation was atypical and rare. About one third of patients have no primary cancer history at the intraocular metastasis diagnosis. The ophthalmologist should recognize intraocular tumors and refer the patient to the oncologist.