PMC9668467_01
Right eye at presentation. (a) Fundus photograph showing choroidal mass and subretinal fluid (arrowheads) with (b) corresponding autofluorescence image; (c) B-scan and (d) optical coherence tomography demonstrate exudative retinal detachment (arrowheads).
CRIOPM2022-3614225.001.jpg
PMC9668467_01_CRIOPM2022-3614225.001.jpg
fig1
Fundus autofluorescence revealed hyper-autofluorescent specks overlying the choroidal mass in the right eye (Figure 1). Optical coherence tomography (OCT) of the retina and B-scan ultrasonography (Figure 1) confirmed a choroidal mass and exudative retinal detachment in the right eye.
(a) Right upper lobe cavitary pulmonary lesion measuring up to 6.0 x 6.3 x 5.0 cm; (b) right superior hilar/mediastinal heterogeneously enhancing mass measuring up to 3.7 x 4.8 x 2.1 cm; (c) smear (Diff-Quik-stained slide, 400 x magnification) showing cohesive malignant cells characterized by enlarged nuclei with pleomorphism and moderate cytoplasm, consistent with metastatic non-small-cell carcinoma; (d) cell block (H&E stain, 200 x magnification) showing tumor cells that are arranged in a cribriforming growth pattern consistent with metastatic adenocarcinoma. This growth pattern has been associated with aggressive behavior; (e) immunohistochemical stain (TTF - 1, 200 x magnification) shows that the tumor cells are strongly and diffusely positive for TTF-1 (nuclear staining). This supports the diagnosis of metastasis from a lung primary (in the setting of a lung mass).
CRIOPM2022-3614225.002.jpg
PMC9668467_01_CRIOPM2022-3614225.002.jpg
fig2
Follow-up CT chest imaging (Figure 2) showed a large right upper lobe cavitary mass, mediastinal adenopathy, and bilateral pulmonary nodules. The biopsy revealed lung adenocarcinoma (Figure 2).
Right eye at one-month follow-up. (a) Fundus photograph showing resolution of choroidal mass with disappearance of subretinal fluid around the lesion (b) corresponding autofluorescence image; (c) B-scan showing reduction in lesion thickness and (d) optical coherence tomography demonstrating resolution of exudative retinal detachment.
CRIOPM2022-3614225.003.jpg
PMC9668467_01_CRIOPM2022-3614225.003.jpg
fig3
At the patient's one-month follow-up appointment, the right eye showed complete resolution of subretinal fluid, shrinking of the right choroidal mass, and improved visual acuity in the right eye (20/30) (Figure 3).