Título / Title

Análise multimodal na metástase ocular secundária a adenocarcinoma de pulmão

Introdução / Purpose

Emphasize multimodal analysis in the metastatic ocular tumor.

Material e Método / Methods

Case report of ocular metastasis secondary to lung adenocarcinoma of Hospital das Clínicas da UNICAMP. Multimodal analysis using Retinography, Autofluorescence, Optical Coherence Tomography (EDI-OCT) and Ocular Ultrasound.

Resultados / Results

Male patient, 65 years old, with lung adenocarcinoma, stage IV, negative EGRF and bone metastasis, currently being submitted to chemotherapy and radiotherapy. Positron emission tomography (PET/CT) did not demonstrate ocular hyper-uptake. On retinography, a single, elevated lesion with a hypopigmented appearance and diffuse limits was observed, affecting the superior temporal arcade and macular area. 8 In the autofluorescence examination, the lesion has a heterogeneous, hypoautofluorescent appearance, with foci of hyperautofluorescence, a pattern also demonstrated by Cennamo. et al. 8 The OCT
demonstrated choroidal elevation in cupuliform plateau, “lumpy bumpy” appearance, irregular, with hyper-reflective points in the topography of the photoreceptor layer, in addition to the presence of subretinal fluid and thinning of the overlying choriocapillary, a pattern considered characteristic of choroidal metastases. 9,10
Ocular ultrasound demonstrates the lesion measurements, C1: 4.02mm C2: 6.87mm, as well as the presence of associated serous retinal detachment and vitreous cellularity. It is a method with elevated accuracy, especially in flat or domed lesions, with non-homogeneous medium-high reflectivity. 8

Discussão e Conclusões / Conclusion

A multimodal analysis of subsequent metastases was of great importance for a more assertive and early diagnosis, with predefined patterns of presentation, enabling the management of metastasis and their complications, in addition to their follow-up.

Palavras Chave

ocular metastasis

Area

CLINICAL RETINA