Choroidal metastasis from lung cancer: A case report

Choroidal metastasis is the most common type of intraocular tumor in adults.Primary cancer that most commonly lead to choroidal metastases include breast cancer and lung cancer. However, ocular symptoms as an initial manifestation of systemic malignancy are rare and often pose a diagnostic challenge. We report the case of a 67-year-old male who presented with progressive diminution of vision and hemianopia in the right eye for 20 days, accompanied by headache and left-sided chest pain. Comprehensive ophthalmic evaluation, including fundus examination and imaging, revealed signs consistent with choroidal involvement and bullous retinal detachment. Subsequent CT imaging of the brain and thorax confirmed a hyperdense lesion in the right globe and multiple expansile lytic lesions with soft tissue components in both lungs. A diagnosis of stage IV lung carcinoma with choroidal metastasis was established. Systemic chemotherapy was initiated; however, the patient succumbed to the illness before the second cycle. This case highlights the need for prompt recognition of atypical ocular presentations as potential indicators of advanced systemic malignancy. Early diagnosis and multidisciplinary evaluation are essential for guiding management and potentially improving both visual and systemic outcomes.