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      Choroidal Metastasis of Non-Small Cell Lung Cancer That Responded to Gefitinib

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          Abstract

          A 52-year-old Japanese woman presented with optical symptoms, including left-sided myodesopsia, blurred vision, narrowed visual field, and diminished visual acuity. Ocular evaluation revealed a metastatic tumor in the choroid. Further examinations identified pulmonary adenocarcinoma as the primary tumor. Because an epidermal growth factor receptor gene ( EGFR) mutation was detected in a biopsy specimen, gefitinib treatment was initiated. Dramatic responses were obtained in the primary tumor and metastatic foci. Optical symptoms improved and remained stable for 5 months during the treatment, until relapse. This report demonstrates that gefitinib is effective for choroidal metastasis of pulmonary adenocarcinoma harboring an EGFR mutation.

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          Emerging treatments for choroidal metastases.

          It has been over a century since Perls described the first case of choroidal metastasis. For the next six decades only 230 cases were described in the literature. Today, however, ocular metastasis is recognized as the most common intraocular malignancy. Thanks to recent advances in treatment options for metastatic disease, patients are living longer, and choroidal metastases will become an increasingly important issue for oncologists and ophthalmologists alike. We summarize the current knowledge of choroidal metastases and examine their emerging systemic and local therapies. Targeted therapies for metastatic lung, breast, and colon cancer--the most common causes of choroidal metastases--are reviewed in detail with the goal of identifying the most effective treatment strategies. Copyright © 2011 Elsevier Inc. All rights reserved.
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            Complete Regression of Choroidal Metastasis Secondary to Non-Small-Cell Lung Cancer with Intravitreal Bevacizumab and Oral Erlotinib Combination Therapy

            Purpose: To report a case of a complete regression of choroidal metastasis secondary to non-small-cell lung cancer (NSCLC). Methods: Retrospective case review of a female patient treated with intravitreal bevacizumab and oral erlotinib combination therapy for choroidal metastases secondary to NSCLC. Best corrected visual acuity (BCVA), fluorescein angiography (FA), optical coherence tomography (OCT), and B-scan ultrasonography were compared during the 4-month treatment period. Results: Four weeks after the third injection of bevacizumab (2.5 mg), the BCVA had improved to 20/40 from 20/200 and the 2 subretinal masses had completely disappeared. FA demonstrated only a retinal pigment epithelial (RPE) window defect with minimal to no leakage. In the B-scan ultrasonography and OCT, no further mass-like lesion was detected. The retina and RPE layer were flattened. Conclusion: Combining intravitreal bevacizumab and oral erlotinib could be another treatment option for patients with choroidal metastasis of NSCLC.
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              Regression of a subfoveal choroidal metastasis of colorectal carcinoma after intravitreous bevacizumab treatment.

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                Author and article information

                Journal
                Case Rep Ophthalmol Med
                Case Rep Ophthalmol Med
                CRIM.OPHMED
                Case Reports in Ophthalmological Medicine
                Hindawi Publishing Corporation
                2090-6722
                2090-6730
                2013
                12 September 2013
                : 2013
                : 213124
                Affiliations
                1Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba 260-8677, Japan
                2Department of Ophthalmology and Visual Science, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba 260-8677, Japan
                3Department of Medical Oncology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba 260-8677, Japan
                Author notes

                Academic Editors: A. A. Bialasiewicz, H. Y. Chen, N. Fuse, and M. Rosner

                Article
                10.1155/2013/213124
                3787632
                19c9fc4e-f100-4792-aad1-25a0e82bb68f
                Copyright © 2013 Iwao Shimomura et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 28 June 2013
                : 14 August 2013
                Categories
                Case Report

                Ophthalmology & Optometry
                Ophthalmology & Optometry

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