ABSTRACT

Uveal metastasis is the most common intraocular malignancy. In order of frequency, it affects choroid, iris, and ciliary body. We report herein the clinicopathologic features and response to therapy in a patient with iris metastasis from a small-cell lung cancer. A 60-year-old male presented with redness and epiphora in his right eye for 4 months. His medical history revealed the presence of a small-cell lung cancer that was detected almost a year ago. He had underwent systemic chemotherapy, local radiotherapy, and prophylactic cranial radiotherapy. The ophthalmological examination revealed amelanotic, yellow-white nodular mass in the iris stroma in his right eye. 27G fine-needle aspiration biopsy was performed under local anesthesia with the primary diagnosis of a metastatic iris tumor. Cytological analysis was consistent with metastatic iris carcinoma from small-cell lung cancer. He subsequently received a total of 3000 cGy (in 15 fractions) radiotherapy from frontal field (4x3 cm) with a 7Mev linear accelerator. The tumor regressed completely one month after therapy and did not recur during the 7-month follow-up. Metastatic iris tumors from small-cell lung cancer are quite rare. Fine-needle aspiration biopsy is required for the final diagnosis. Local radiotherapy is usually effective in controlling these tumors.