Isolated choroidal metastasis as first site of disease progression: a case report

Abstract

Background: Choroidal metastasis is rare and ocular examination is not routinely recommended as part of staging work up in breast cancer management. Clinical picture: We present a case of choroidal metastasis in female breast cancer. Breast imaging and staging evaluation suggested multicentric breast cancer without lymph node metastasis or systemic metastasis. After total right mastectomy with sentinel lymph node biopsy, the final pathologic stage was pT2N0, ER (+), PR (+), c-erbB2 (2+), and FISH (-). On the third day following surgery, she complained of blurred vision in her left eye. Ophthalmologic evaluation showed choroidal metastasis from breast cancer. The visual acuity in her left eye was 20/50. Result: After concomitant delivery of chemoradiation therapy, the choroidal lesions improved dramatically and vision acuity in her left eye recovered to 20/20. Conclusion: Clinicians should consider the possibility of choroidal metastasis when breast cancer patients complain of ocular symptoms.