Ocular Metastatic Tumor in a Patient With Hepatocellular Carcinoma

While orbital floor metastasis from hepatocellular carcinoma (HCC) has been reported, ocular (eyeball) metastasis is exceedingly rare. Most ocular metastases originate from breast or lung cancer. In this article, we present the case of a 65-year-old man diagnosed with HCC with central necrosis (cT3N0M0, stage III) based on characteristic imaging findings. As liver resection was not indicated, biliary drainage, ascites control, and transcatheter arterial chemoembolization (TACE) were performed. On day 62 of admission, he developed right-sided visual disturbance accompanied by severe pain. A fundus examination and head CT scan by an ophthalmologist indicated a tumor in the right eye. A whole-body CT scan was performed again, revealing no other distant metastases apart from the eye. Based on the clinical course, ocular metastasis from HCC was diagnosed. Due to poor general condition, enucleation was not performed. Pain management with medication alone was insufficient, but two sessions of radiation therapy significantly alleviated the pain. Prompt treatment is crucial as ocular metastasis is associated with pain and vision impairment, significantly affecting the patient's quality of life. When systemic treatment is not feasible, local treatment options, such as radiation therapy, become important. Radiation therapy for ocular metastases is valuable, as it can provide rapid symptomatic relief.