Intraocular metastasis of metastatic carcinoma is relatively rare, although it is the most common malignancy affecting the eye. Choroid is the most commonly involved site, whereas iris is involved very infrequently. The most common primary tumor of the intraocular metastasis is the breast cancer in total and lung cancer in men.To our knowledge, intraocular metastasis of lung adenocarcinoma has not reported in Korea. We experienced two lung cancer patients who had developed a metastaticlesion to the iris and choroid,so we report these with the review of related literatures.
Adenocarcinoma ; Breast Neoplasms ; Choroid ; Humans ; Iris ; Korea ; Lung Neoplasms* ; Lung* ; Neoplasm Metastasis*

Adenocarcinoma ; pathology ; Ciliary Body ; Humans ; Iris Neoplasms ; pathology ; Lung Neoplasms ; pathology ; Male ; Middle Aged ; Uveal Neoplasms ; pathology

Metastatic tumors to the eye are probably the most common type of intraocular malignancies. The choroid is the most common site of involvement. Though the iris is a less common site of uveal involvement, metastases to the iris may occur and may produce a variety of clinical findings. The most common metastatic tumor to the eye is breast tumor and lung tumor is second, whereas the prompt most common metastatic tumor to the iris is lung tumor and breast tumor is second. The iris lesion may be the first presentation of the cancer and should make a search for the primary tumor. The diagnosis of metastatic tumor to the iris can be established by cytologic examination of aqueous. Local irradiation can spare the patient an enucleation and can preserve the eye for the generally few months of life that remain. Although the prognosis for vision is usually good, the prognosis for life is poor. The authors describe a 37 year old male patient having a metastasis from oat cell carcinoma of the lung to iris, which begins to respond to chemotherapy.
Adult ; Breast Neoplasms ; Carcinoma, Bronchogenic* ; Carcinoma, Small Cell ; Choroid ; Diagnosis ; Drug Therapy* ; Humans ; Iris* ; Lung ; Male ; Neoplasm Metastasis ; Prognosis

Congenital neurofibromatosis type 1, or Von Recklinghausen's disease is an autosomal dominant disorder characterized by neurofibroma, pigmented skin lesions (Cafe-au-lait macules), iris hamartomas and meningeal tumors, but rarely, by autonomic ganglia tumors, such as pheochromocytomas. We have experienced an intrathoracic and chest wall plexiform neurofibroma intimately contacted with collagenoma-like, dome-shaped skin lesions of type 1 neurofibromatosis, which are relatively rare and interesting, but can be regarded as typical findings in neurofibromatosis. Although intrathoracic neurogenic tumors are not uncommon, cases like ours are interesting, as the feature of collagenoma-like skin neurofibroma was very closely apposited with chest wall neurofibroma. Our case had no aypical features of malignancy and the patient was clinically followed up without recurrence.
Ganglia, Autonomic ; Hamartoma ; Humans ; Iris ; Meningeal Neoplasms ; Neurofibroma* ; Neurofibroma, Plexiform* ; Neurofibromatoses ; Neurofibromatosis 1* ; Pheochromocytoma ; Recurrence ; Skin ; Thoracic Wall* ; Thorax*

Neurofibromatosis type 1 (NF1) is an autosomal dominant disease, characterized by cafe-au-lait spot, axillary and inguinal freckle, peripheral neurofibroma and pigmented iris hamartoma. The various cancer incidences are increased in the NF1. But NF1 with breast cancer is rare. In this report we present a case of a 46-year-old NF1 female with a bilateral metachronous breast cancer. The patient has no BRCA2 mutation, but there are two unclassified variants in the exon 11 of BRCA1. The possibility of LOH of BRCA1 gene in the cancer tissue cannot be excluded.
Breast ; Breast Neoplasms ; Cafe-au-Lait Spots ; Exons ; Female ; Genes, BRCA1 ; Hamartoma ; Humans ; Incidence ; Iris ; Melanosis ; Middle Aged ; Neurofibroma ; Neurofibromatoses ; Neurofibromatosis 1

We report a case of ciliary body melanocytoma in a Korean patient, which presented as an intermittently painful pigmented iris mass and was successfully managed by iridocyclectomy. A 52-year-old healthy man presented with an irregularly-shaped and heavily-pigmented mass at the iris root of his right eye. Visual acuity of the right eye was 20/20 with normal intraocular pressure. Ultrasound biomicroscopy showed a 1.5x1.3-mm ciliary-body mass with extension into the iris root. Iridocyclectomy with scleral resection under a lamellar scleral flap was performed, and the histopathologic features of the resected tissue were consistent with melanocytoma of the ciliary body. The patient's visual acuity remained 20/20 with good postoperative cosmesis. During one year of follow-up, no signs of tumor recurrence were seen, and the patient reported resolution of the intermittent ocular pain in the involved eye.
*Ciliary Body/surgery ; Humans ; Iris/*pathology/*physiopathology/surgery ; Male ; Middle Aged ; Neoplasm Invasiveness/*pathology/physiopathology ; Nevus/*pathology/surgery ; Pain/*physiopathology ; Uveal Neoplasms/*pathology/surgery

Von Recklinghausen's disease is an autosomal dominant hereditary disease associated with characteristic cafeau-lait spots of skin and multiple neurofibromatosis. It is complicated by malignancies, which in most cases is neurofibrosarcoma. The development of lung cancer in von Recklinghausen's disease is rare. A 61-year-old male was admitted for cough and sputum for 20 days. He had multiple cafe-au-lait spots and subcutaneous neurofibromas in whole body area and Lisch nodules in both iris and he had been diagnosed von Recklinghausen s disease 35 years ago. Chest radiography showed emphysematous buliae in both upper lung field and mass in right upper lung field. Chest CT scan revealed subcarinal lymph node enlargement. Bronchoscopic biopsy was done in mass in superior segment of right lower lobe and the results showed squamous cell carcinoma. The presence of von Recklinghausen's disease and lung cancer are noteworthy.
Biopsy ; Cafe-au-Lait Spots ; Carcinoma, Squamous Cell ; Cough ; Genetic Diseases, Inborn ; Humans ; Iris ; Lung Neoplasms* ; Lung* ; Lymph Nodes ; Male ; Middle Aged ; Neurofibroma ; Neurofibromatoses ; Neurofibromatosis 1* ; Neurofibrosarcoma ; Radiography ; Skin ; Sputum ; Thorax ; Tomography, X-Ray Computed

Type 1 neurofibromatosis (von Recklinghausen's disease, NF-1) is an autosomal-dominant neurocutaneous-disorder characterized by systemic cafe'-au-lait spots, multiple cutaneous neurofibromas, axillary or inguinal freckling, and Lisch nodules (pigmented iris hamartomas). Approximately 10-25% of NF1 patients have gastrointestinal neoplasms. Gastrointestinal stromal tumor (GIST) in patients with neurofibromatosis is most commonly found in the small bowel and the stomach, and approximately 60% of such patients have multiple tumors or multiple tumor sites. Although, the increased incidence of GIST in patients with neurofibromatosis is well documented in pathology literature in English, but has rarely been documented in Korea. Here, we report a case of multiple GISTs in a 48-year-old woman accompanied by NF1. She was admitted to Yeungnam University Hospital with complaints of melena and dyspnea. A contrast-enhanced computed tomography (CT) scan revealed that multiple soft tissue masses were occupying the entire peritoneal cavity. An ultrasonogram- guided biopsy was performed and the tumors were found to have been composed of tumor cells that were positive for c-kit protein. The patient was put on Imatinib mesylate treatment, and further follow-up will be carried out.
Biopsy ; Dyspnea ; Female ; Follow-Up Studies ; Gastrointestinal Neoplasms ; Gastrointestinal Stromal Tumors* ; Humans ; Incidence ; Iris ; Korea ; Melena ; Mesylates ; Middle Aged ; Neurofibroma ; Neurofibromatoses ; Neurofibromatosis 1* ; Pathology ; Peritoneal Cavity ; Proto-Oncogene Proteins c-kit ; Stomach ; Imatinib Mesylate

PURPOSE: To report a case of Intraoperative Floppy Iris Syndrome (IFIS) experienced during pars plana vitrectomy and phacoemulsification in a patient using tamsulosin, which is a selective alpha 1 adrenergic antagonist. CASE SUMMARY: A 77-year-old male who had used tamsulosin for the previous month for prostate cancer visited our clinic with left visual disturbance, that had developed a week earlier. The best-corrected visual acuity of the left eye was 0.02 and both pupils showed incomplete mydriasis. Pars plana vitrectomy and phacoemulsification with PCL implantation were performed on his left eye to correct a left cataract and retinal vein occlusion with vitreous hemorrhage. Phacoemulsification idenfied a billowing iris and progressive pupillary constriction. Therefore, we administered an intracameral epinephrine injection and applied an iris hook. The procedure was completed successfully without any complications. The best-corrected visual acuity of the left eye was good as at 0.9, and iris depigmentation and atrophy were checked two months postoperatively in the right eye, which had not had any previous surgical history. CONCLUSIONS: A detailed medical history taking is essential because IFIS may raise the risk of intraoperative complications, such as posterior capsule rupture, especially when the small pupil is small. Safe procedures must be planned with cessation of tamsulosin at least a week preoperatively.
Adrenergic Antagonists ; Aged ; Atrophy ; Cataract ; Constriction ; Epinephrine ; Eye ; Humans ; Intraoperative Complications ; Iris ; Male ; Medical History Taking ; Miosis ; Mydriasis ; Phacoemulsification ; Prostatic Neoplasms ; Pupil ; Retinal Vein Occlusion ; Rupture ; Sulfonamides ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage