Alabi Rolake O, Haq Zeeshan, Bloomer Michele M, Afshar Armin R
Department of Ophthalmology, Wayne & Gladys Valley Center for Vision, University of California, San Francisco, San Francisco, CA, USA.
Ophthalmic Pathology Service, Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, USA.
Am J Ophthalmol Case Rep. 2023 Jun 5;31:101863. doi: 10.1016/j.ajoc.2023.101863. eCollection 2023 Sep.
Tumor metastases to the retina are a relatively rare occurrence. We report a unique case of retinal metastasis of a systemic malignancy with clinical and histopathologic correlations.
A 62-year-old female with a history of stage IV small cell carcinoma of the lung (SCC, status post chemotherapy and maintenance immunotherapy) presented with hand motions vision and vitreous hemorrhage, status post prior vitrectomy and biopsy that was non-diagnostic. She was found to have unilateral retinal metastatic tumor and underwent a repeat vitrector-assisted biopsy which confirmed the diagnosis. The eye became blind and painful due to recurrent non-clearing vitreous hemorrhage and ghost cell glaucoma and was enucleated. Detailed histopathologic analysis of the globe confirmed small cell carcinoma metastatic to the retina and vitreous cavity and sparing the choroid.
This case demonstrates the importance of maintaining a high index of suspicion for metastasis in patients with a known history of malignancy who present with new vitreoretinal lesions.
肿瘤转移至视网膜相对罕见。我们报告一例系统性恶性肿瘤视网膜转移的独特病例，并进行临床和组织病理学相关性分析。
一名62岁女性，有IV期肺小细胞癌病史（接受化疗和维持免疫治疗后），因视力仅存手动且伴有玻璃体出血就诊，此前已行玻璃体切除术及活检，但结果未明确诊断。发现她患有单侧视网膜转移瘤，遂再次接受玻璃体切除辅助活检，确诊为视网膜转移瘤。由于反复出现玻璃体出血不吸收及鬼影细胞性青光眼，患眼失明且疼痛，最终行眼球摘除术。对眼球进行详细的组织病理学分析证实，小细胞癌转移至视网膜和玻璃体腔，脉络膜未受累。
该病例表明，对于有已知恶性肿瘤病史且出现新的玻璃体视网膜病变的患者，高度怀疑转移瘤具有重要意义。
