External Beam Radiation Therapy for Metastatic Tumor to the Iris: A Case Report and Brief Literature Review

Tumor metastases involving the iris are rare and represent about 3% of metastases to the uveal tract. The typical presentation is a patient with a known history of carcinoma who develops blurry vision, ocular pain, and/or eye redness, which may be erroneously diagnosed as uveitis. In this case, we report the workup, diagnosis, and treatment of a 76 year old man with a history of node negative multi-focal adenocarcinoma of the lung who was found to have a left iris metastasis. He presented with blurry vision and left eye pain. Exam revealed a 7 x 7 mm amelanotic ciliary body mass, which was ultimately biopsied and found to be consistent with his lung primary. He was treated with external beam radiation therapy, 3000cGy in 10 fractions, to the left globe. His three and nine-month follow up MRIs showed good treatment response and he is clinically without disease progression. EBRT is a safe and effective modality for the treatment of iris metastases.

Iris metastasis of diffuse large B-cell lymphoma misdiagnosed as primary angle-closure glaucoma: A case report and review of the literature

Background Lymphoma with intraocular metastasis is an uncommon and serious disease. We describe a case of diffuse large B-cell lymphoma (DLBCL) with iris metastasis. Meanwhile, we refer to published case reports retrieved via a PubMed search to summarize this rare disease. Case presentation Glaucoma and uveitis symptoms were found in the left eye of a 50-year-old woman upon admission to the hospital. After treatment and pathological examination, the iris of her left eye was diagnosed with DLBCL. Given the patient’s unfavorable treatment options in the local hospital, primary enucleation was offered as a therapeutic option. Conclusions Iris metastasis of systemic lymphoma is an extremely rare ophthalmic disease with poor prognosis. Ophthalmologists should be able to definitively and differentially diagnose eye symptoms and pay attention to systemic conditions to provide a series of optimized treatments.