Unilateral Choroid Metastasis as an Initial Presentation of Lung Cancer-Two Case Reports

癌症是台灣2004年十大死因之首，而肺癌則佔癌症死亡原因的第一位，故肺癌已成為國人重大健康問題之一。而肺癌常見的遠處轉移包括了腦部、骨頭、肝臟以及腎上腺，眼球脈絡膜則是較罕見的轉移位置，而其診斷主要是根據症狀及影像學之表現。然而，臨床上我們並不常規篩選病人是否有脈絡膜轉移，主要是因為無症狀之脈絡膜轉移病人比例甚低。對於已經有眼睛症狀的病人，考慮到其生活品質，正確診斷及積極治療是必須的，而放射線治療是目前最常選用的治療方式。在此我們報告兩位病人，他們皆以視力模糊作為最初之表現，最後診斷為肺癌合併腦部及脈絡膜轉移。在這兩個案例中，病人皆拒絕眼部之放射治療而選擇全身性化學治療及頭部之放射線治療，並且得到主觀之視力改善，且其中一病例於眼底鏡檢查下顯示腫瘤縮小。

關鍵字

脈絡膜轉移；肺癌

並列摘要

Lung cancer is 1 of the major health problems in the world and the leading cause of cancer death in Taiwan. Well-known metastatic sites of lung cancer include the lung, lymph nodes, brain, bone, liver, etc. Choroid metastasis is rare and the diagnosis is based primarily on clinical findings supplemented by imaging studies. However, clinicians do not routinely evaluate the possibility of intraocular metastasis, mainly because of the low incidence of asymptomatic choroid metastasis. The most commonly used treatment in patients with symptomatic intraocular metastasis is radiotherapy. Herein, we report the cases of 2 patients who had blurred vision as the initial presentation, and were diagnosed with adenocarcinoma of the lung with brain and choroid metastasis. They refused radiotherapy of the eye, and commenced systemic chemotherapy and brain radiation therapy. One received plaxitaxel and the other received vinorelbine. Throughout serial follow-ups, their visual acuity subjectively improved, along with a reduction in the size of the intraocular tumor, as seen by ophthalmoscopic examination in 1 case.

並列關鍵字

choroid metastasis ； lung cancer

國際替代計量

Unilateral Choroid Metastasis as an Initial Presentation of Lung Cancer-Two Case Reports

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