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The most common sites of lung cancer metastases are pleura, bone, brain, pericardium and liver. 1 Tumor metastasis to the eye is a rare complication of lung cancer. Metastatic cancer to the ocular region most often involves the uveal tract, however, most uveal metastases occur in the posterior uvea, and iris metastases are relatively rare. We describe a patient with adenocarcinoma of the lung metastatic to the iris as the first clinical sign without symptoms of lung cancer.CASE REPORTIn September 2003, a 54-year-old man was presented at outpatient department of ophthalmology because of progressive blurred vision and discomfort in his left eye during the previous week. Ocular examination of the left showed the best-corrected visual acuity 0.4 and intraocular pressure of 34 mmHg. Slit lamp examination of the left eye showed a saddle-shaped yellowish tumor with prominent blood vessels involving the iris in the temporal quadrant and a dome-shaped yellow-brown mass at the inferior-temporal pupil margin (Fig. 1). Tyndall sign was ++ and moderate cells in the left anterior chamber. Brownish material and blood vessels were found in the inferior and temporal chamber angle gonioscopically. Visual acuity and slit lamp examination of the right eye were not significant. Ophthalmoscopy revealed the cup/disc ratio was 0.3 and 0.5 for the right and left eye respectively. The retinae of both eyes were otherwise within normal limits. Ultrasound biomicroscopy showed mass lesion in the iris of left eye. Ciliary body was also involved. He had no other systemic symptom and no history of systemic cancer. His father died of lung cancer; one of his brothers died of colon cancer; his son was diagnosed as brain tumor. Iris and ciliary body metastasis and secondary glaucoma of the left eye were diagnosed.
The most common sites of lung cancer metastases are pleura, bone, brain, pericardium and liver. 1 Tumor metastasis to the eye is a rare complication of lung cancer. Metastatic cancer to the ocular region most often involves the uveal tract, however, most uveal metastases occur in the posterior uvea, and iris metastases are relatively rare. We describe a patient with adenocarcinoma of the lung metastatic to the iris as the first clinical sign without symptoms of lung cancer. CASE REPORTIn September 2003, a 54-year-old man was presented at outpatient department of ophthalmology because of progressive blurred vision and discomfort in his left eye during the previous week. Ocular examination of the left showed the best-corrected visual acuity 0.4 and intraocular pressure of 34 mmHg. Slit lamp examination of the left eye showed a saddle-shaped yellowish tumor with prominent blood vessels involving the iris in the temporal quadrant and a dome-shaped yellow-brown mass at the inferior-temporal pupil margin (Fig. 1). Tyndall sign was ++ and moderate cells in the left anterior chamber. Brownish material and blood vessels were found in the inferior and temporal chamber angle gonioscopically. Visual acuity and slit lamp examination of the right eye were not Ophthalmoscopy revealed the cup / disc ratio was 0.3 and 0.5 for the right and left eye respectively. The retinae of both eyes were otherwise within the normal limits. Ultrasound biomicroscopy showed mass lesion in the iris of left eye. Ciliary body was also involved. His father was of lung cancer; one of his brothers died of colon cancer; his son was diagnosed as brain tumor. Iris and ciliary body metastasis and secondary glaucoma of the left eye were diagnosed.