CLINICAL CASE OF NON-TYPICAL METASTASIS OF NEUROENDOCRINE LUNG CARCINOMA TO THE VASCULAR MEMBRANE OF THE EYE

Abstract

Background: Metastases in eye structures are rare (1–5% cases at systemic spread of different malignancies, mainly breast and lung cancers). The prognosis is poor. The overall survival usually does not exceed 12 or even 6 months. If metastases are found in the choroid membrane, the probability that the patient has multiple metastatic lesions of other organs increases significantly. Lung neuroendocrine neoplasms are rare (1–2% of all malignancies in adults), but mainly aggressive tumors. They are cha­racterized by “blurred”, nonspecific clinical symptoms, the correct diagnosis is delayed seriously, and distant metastases are seen in more than 40% of patients (usually in chest structures, liver, bones, brain, and adrenal glands; metastasis to vascular membrane of the eye ranks the 6^th place). Case report: Own clinical observation of a male patient with rare metastasis of lung neuroendocrine carcinoma to the choroid of the left eye is presented. The disease is manifested by an ocular metastasis, which was initially considered an embryonic tumor. Other metastatic lesions (hilar lymph nodes, liver, soft tissues) were detected on computed tomography a little bit later. The diagnostic algorithm using routine histological examination and immunohistochemistry, including detection of neuroendocrine markers (chromogranin A, synaptophysin), cytokeratin 7 and Ki-67 expression in primary and metastatic tumors is described.