Right visual loss due to choroidal metastasis of a papillary adenocarcinoma of the lung: a case report.

The symptomatic choroidal metastasis is a rare manifestation of lung cancer. The aim of this study was to present a clinical case of choroidal metastasis associated with multiple intracerebral metastases from a papillary adenocarcinoma of the lung diagnosed simultaneously with its metastases. We present the case of a 40-year-old male patient, smoker, admitted to the Neurosurgery Clinic II, "Prof. Dr. Nicolae Oblu" Emergency Hospital, Iassy, Romania, for right hemiparesis, headache, right visual loss, dysphonia and swallowing disorders occurring six days earlier. Previous medical history showed that he was diagnosed with a stage IV cancer located in the lower lobe of the left lung a week before. Ophthalmoscopic examination of the right eye revealed total secondary serous retinal detachment. Contrast cranial-cerebral computed tomography (CT) scan revealed multiple lesions compatible with the diagnosis of supratentorial intracerebral metastases in the left hemisphere, as well as an intraocular choroidal metastasis. The rolandic brain tumor was surgically removed and the cyto- and histopathological exam established the diagnosis of an intracerebral metastasis from a papillary adenocarcinoma of the lung. After a week, the patient was referred to an oncology unit for the initiation of oncology and palliative care. We emphasize the importance of an ophthalmological screening of patients with intracerebral metastases in order to eventually identify a choroidal metastasis, as the recognition and early treatment of this entity could improve the quality of patient's life.