Uveal metastasis is the most common intraocular malignancy. In order of frequency, it affects choroid, iris, and ciliary body. We report herein the clinicopathologic features and response to therapy in a patient with iris metastasis from a small-cell lung cancer. A 60-year-old male presented with redness and epiphora in his right eye for 4 months. His medical history revealed the presence of a small-cell lung cancer that was detected almost a year ago. He had underwent systemic chemotherapy, local radiotherapy, and prophylactic cranial radiotherapy. The ophthalmological examination revealed amelanotic, yellow-white nodular mass in the iris stroma in his right eye. 27G fine-needle aspiration biopsy was performed under local anesthesia with the primary diagnosis of a metastatic iris tumor. Cytological analysis was consistent with metastatic iris carcinoma from small-cell lung cancer. He subsequently received a total of 3000 cGy (in 15 fractions) radiotherapy from frontal field (4x3 cm) with a 7Mev linear accelerator. The tumor regressed completely one month after therapy and did not recur during the 7-month follow-up. Metastatic iris tumors from small-cell lung cancer are quite rare. Fine-needle aspiration biopsy is required for the final diagnosis. Local radiotherapy is usually effective in controlling these tumors.
Keywords: External beam radiotherapy, fine-needle aspiration biopsy, iris, metastasis, small-cell lung cancer