Wysiękowe odwarstwienie siatkówki jako pierwszy objaw rozsianego raka płuc – opis przypadku
Autorzy: Anna Modrzejewska, Karol Krzystolik, Wojciech Lubiński, Monika Modrzejewska

Exudative Retinal Detachment as a First Symptom of Metastatic Lung Cancer – Case Report

Wydanie 2/2018
str. 108 – 111

Autorzy: Anna Modrzejewska 1 , Karol Krzystolik 1 , Wojciech Lubiński 2 , Monika Modrzejewska 2

1 I Katedra i Klinika Okulistyki Pomorskiego Uniwersytetu Medycznego w Szczecinie
Kierownik: prof. dr hab. n. med. Anna Machalińska
2 II Katedra i Klinika Okulistyki Pomorskiego Uniwersytetu Medycznego w Szczecinie
Kierownik: prof. dr hab. n. med. Wojciech Lubiński

Summary: The aim of this paper is to describe exudative retinal detachement as the first sign preceding the diagnosis of neoplastic lung disease.

Case study: The authors presented the case of a 50 year old woman, who came to the Ophthalmological Outpatient Clinic due to vision deterioration in the right eye lasting for 3 weeks, without concomitant symptoms coming from other organs. The best right eye visual acuity was 2/50 (Snellen Chart). The eye fundus examination showed two extensive and tense blisters of the detached retina, without visible tear. The ultrasonography and optical coherence tomography tests confirmed exudative retinal detachement.

The fluorescein angiography examination revealed fluorescein leakage in the area of retinal arterial vessels of the superior temporal arch as well as within the detachment, and a massive dye release in sharp detachments borders in the venous phase. Laboratory tests ruled out parasite, inflammatory and infectious diseases. Incorrect values of Erythrocyte Sedimentation Rate, C-Reactive Protein, D-dimers, Fibrynogen, Cancer Antigen 125 and Carcinoembryonic antigen. Detailed radiological lung, brain and abdominal cavity diagnostics (Computer Tomography, Magnetic Resonance Imaging) showed the presence of seeded neoplastic process in the lungs with metastases to the brain. The final diagnosis of lung adenocarcinoma at the stage of T2N3M1 seeding was made on the basis of a histopathological test.

Conclusions: Exudative retinal detachement may be the first ophthalmological sign of disseminated neoplastic process. Detailed interview and extended multiorgan diagnostics should be an essential part of management in investigating the causes of this ophthalmological condition.