Treatment of Choroidal Metastasis from Epidermal Growth Factor Mutant Non-Small Cell Lung Cancer with First-line Osimertinib Therapy - PubMed (original) (raw)

Case Reports

. 2022 Jan 21;17(1):130-134.

doi: 10.18502/jovr.v17i1.10178. eCollection 2022 Jan-Mar.

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Case Reports

Treatment of Choroidal Metastasis from Epidermal Growth Factor Mutant Non-Small Cell Lung Cancer with First-line Osimertinib Therapy

Anderson N Vu et al. J Ophthalmic Vis Res. 2022.

Abstract

Purpose: To illustrate the regression of a metastatic lesion through ophthalmic imaging and correlating findings with standard chest imaging and treatment with osimertinib, an oral chemotherapy agent specific to Epidermal Growth Factor Receptor + Non-small Cell Lung Cancer (EGFR+ NSCLC).

Case report: A 63-year-old Asian male presented to ophthalmology with a complaint of left blurry vision. Initial ophthalmic exam revealed a choroidal lesion and imaging results highlighted a spiculated lung mass with brain and bony metastases. Osimertinib was chosen for its specificity and ability to cross the blood-brain barrier. Follow-up ophthalmic and radiographic imaging were repeated over the course of treatment.

Conclusion: After the initiation of osimertinib, ophthalmic and computed tomography imaging highlighted the regression of the ocular metastatic disease and primary malignancy, respectively.Osimertinib is an effective first-line treatment of EGFR+ NSCLC and corresponding metastatic sites. Additionally, ophthalmic imaging can be used to monitor general response to chemotherapy agents when ocular metastasis is identified.

Keywords: Choroidal Neoplasm; Multimodal Imaging; Neoplasm Metastasis; Non-small Cell Lung; Osimertinib; Carcinoma.

Copyright © 2022 Vu et al .

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1

Figure 1

(a) Color fundus photography showing lateral boundaries (dotted lines) of tumor above fovea. White circles are the same bifurcation of vessels in each image. (b) Autofluorescence showing speckled pattern and extent of subretinal fluid (dotted lines).

Figure 2

Figure 2

(a) Optical coherence tomography showing resolving subretinal fluid and flattening of retina. (b) Bscan ophthalmic ultrasound showing regression of metastatic lesion.

Figure 3

Figure 3

Positron emission and computed tomography showing primary epidermal growth factor receptor + non-small cell lung carcinoma. Osimertinib initiated after two to three month time point.

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