Abstract
BackgroundThe retina is an uncommon site for metastases, in particular from solid tumors. Some authors have reported a recent increase in the incidence of metastases in infrequent sites, such as brain or bone, probably due to the expanded treatment options and the resulting improved survival. Choroidal metastasis is the most common type of intraocular malignancy. The most common primary sites associated with choroidal metastasis are breast cancer in women and lung cancer in men. Treatment options are limited, but they must be discussed and adapted to the patient profile.Cases presentationWe report a case of a 62-year-old Moroccan man with a history of monophthalmitis secondary to a war injury of 30 years’ duration. He has been followed for 28 months for metastatic clear-cell renal carcinoma. The first-line treatment was effective for 24 months, before disease progression as retinal metastasis and accentuation of lung metastases. A second-line treatment with everolimus resulted in marked improvement of symptoms, complete recovery of visual function, and partial response in retinal localization.ConclusionsChoroidal metastasis of renal cancer is a rare situation that must be actively sought in order to arrive at a suitable therapeutic approach.
Highlights
The retina is an uncommon site for metastases, in particular from solid tumors
Choroidal metastasis of renal cancer is a rare situation that must be actively sought in order to arrive at a suitable therapeutic approach
Symptomatic choroidal metastasis is less common than asymptomatic choroidal metastasis, visual disturbance caused by cancer metastasis from other organs is one of the most important limits on the quality of life of patients with cancer [4]
Summary
The occurrence of retinal metastasis is a rare presenting manifestation of solid tumors [1]. Metastatic tumors are the most common intraocular malignancy in adults [1]. They are most commonly found in the choroid and less frequently in the iris and ciliary body [2]. Symptomatic choroidal metastasis is less common than asymptomatic choroidal metastasis, visual disturbance caused by cancer metastasis from other organs is one of the most important limits on the quality of life of patients with cancer [4]. We report a case of a patient successfully managed with everolimus as second-line treatment of retinal metastasis from renal cancer. Evaluation after 4 months revealed marked improvement of symptoms and complete recovery of visual function, despite the persistence of imaging-detected retinal metastasis that was significantly decreased in size (Fig. 5). The use of everolimus was associated with the occurrence of grade 2 mucositis, which rapidly resolved after symptomatic treatment
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