PMC3385279_01
(a) Bilateral choroidal metastasis seen as a pale patch like appearance on fundoscopy overlying the macula on the right and (b) temporal to the equator on the left. (c) Positron emission tomography-computed tomography showing high-grade neoplasm in the right upper lobe lung with mediastenal lymphadenopathy. (d) Ninety-five percent isodose covering the bilateral orbits delivered by bilateral 15-degree wedged portals
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F1
On fundoscopy, the appearance was of a pale plateau lesion overlying the macula in the right eye and a temporal elevation at the equator in the left eye [Figure 1a and b]. Positron emission tomography-CT performed to determine the site of primary and extent of metastatic disease revealed high-grade metabolically active disease (Standardized uptake value max=20) within the collapsed apical region of the right lung, suggestive of neoplastic primary with extensive mediastinal, hilar and cervical lymphadenopathy [Figure 1c]. She received external beam radiotherapy with 15-degree wedged bilateral portals to bilateral orbits to a dose of 3000 cGy in 10 fractions delivered as 300 cGy per fraction, one fraction per day [Figure 1d].