A case of choroidal metastasis from renal cell carcinoma significantly reduced by radiotherapy

Abstract

Introduction: Choroidal metastasis from renal cell carcinoma is relatively rare and unresponsive to systemic treatment.

Case presentation: A man in his eighties with left renal cell carcinoma and pulmonary metastasis developed visual impairment in the left eye during primary treatment with ipilimumab and nivolumab followed by secondary treatment with cabozantinib. Consultation with an ophthalmologist revealed choroidal metastasis, which was subsequently treated with local radiotherapy (3 Gy × 10 Fr), resulting in a significant reduction in the metastatic lesions.

Conclusion: If visual impairment arises while treating renal cell carcinoma, it is essential to consider the possibility of intraocular metastasis. In terms of treatment, local therapies such as radiotherapy should be taken into consideration.

Keywords: choroidal metastasis; radiotherapy; renal cell carcinoma.

Fig. 1

(a) Non‐contrast coronal computed tomography (CT) image showing a tumor measuring 34 mm in diameter in the left upper pole of the kidney. (b) Axial CT image showing multiple lung metastases in both lung fields.

Fig. 2

(a) Fundus examination revealing serous retinal detachment and a tumor in the choroid. (b) T2‐weighted axial magnetic resonance imaging (MRI) revealing a hypointense mass within the left eye measuring 10 mm in diameter.

Fig. 3

(a) Fundus examination after treatment found no tumor but the retinal detachment persisted. (b) T2‐weighted axial magnetic resonance imaging (MRI) showing that the choroidal metastasis treated with radiotherapy at 30 Gy gradually disappeared over 15 months.