[Tumor metastases of the choroid: clinical picture and histology (author's transl)].

This paper is based on 21 patients with metastases of the choroid from extraocular tumors, observed over a period of 25 years (1952--1977) at Erlangen University Eye Clinic. Approximately 70% of these relatively rare metastases of the choroid are caused by cancer of the breast. Ophthalmoscopically, they are usually localized to the left of the posterior pole and are yellowish. In about 20% of the cases both eyes are affected. Since breast cancer is the most frequent cause of the primary tumor, women in the 40 to 60 age group are the most common sufferers. On the other hand, it is worth mentioning that in 2 cases the metastases were the first signs of any type of malignancy. Typical is the relatively flat, shell-like growth. In cytological specimens the portion of the retina covering the tumor normally shows no evidence of cystic degenerative change, in contrast to malignant melanoma. In view of the short average life expectancy of about 9 months, therapy should consist in preserving the eye and thus some degree of vision. Radiotherapy, chemotherapy or cytostatic therapy whould be tried. Enucleation is only indicated where there is severe pain, secondary glaucoma, amaurosis or if it is impossible to differentiate from a malignant melanoma.