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16 Cards in this Set
- Front
- Back
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The commonest sources of choroidal metastasis in males are:
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lung (40%), unknown (30%), gastrointestinal tract (10%), kidney (5%) and prostate (5%).
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The commonest sources of choroidal metastases in females are:
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breast (70%), lung (10%), and unknown (10%).
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Intraocular metastases usually occur in:
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posterior choroid.
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The clinical features of anterior uveal metastases include:
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gray/white mass; iridocyclitis; secondary glaucoma; rubeosis iridis; hyphema; and irregular pupil.
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Anterior segment examination should include:
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slit-lamp biomicroscopy and high-resolution ultrasonography.
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Posterior uveal metastases present with
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visual loss, pain and/or photopsia.
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Clinical features are
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placoid amelanotic tumor, retinal detachment, leopard spots, dilatation of overlying epibulbar vessels, necrosis, uveitis.
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Metastases to optic nerve
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are rare, causing disc edema and visual loss.
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Metastases to retina
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are very rare, forming white non-cohesive lesions with vitreous seeds
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A prior history of malignancy occurs in
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90% of patients with breast mets, less commonly in patients with another primary
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Ancillary tests include:
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ultrasonography and FNAB, with immunohistochemistry.
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On ultrasonography, metastases show
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moderate-to-high reflectivity with a mushroom shape being very rare
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Patients with a suspicion of metastasis should have
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imaging of breast, chest, abdomen and pelvis, possibly with PET-CT.
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Survival prognosis is best in patients with
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carcinoid and breast carcinoma
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Treatment of uveal metastases include
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systemic therapy, if that is planned in any case; external beam radiotherapy, brachytherapy, transpupillary thermotherapy and laser photocoagulation. (also PDT and Avastin?). Rarely, enucleation is needed.
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Secondary invasion of the globe can occur with
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conjunctival tumors, particularly mucoepidermoid carcinoma or spindle cell variant
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