Bilateral Choroidal Metastases from Endobronchial Carcinoid Treated with Somatostatin Analogues



Deborah De Bruyn1, *, Jan Lamont2, Erik Vanderstraeten3, Simon Van Belle4, Elise Platteau1, 5, Julie De Zaeytijd1, Kristien P. Hoornaert1, 5
1 Department Ophthalmology, Ghent University Hospital and Ghent University, Ghent, Belgium
2 Department Pneumology, Maria Middelares Hospital, Ghent, Belgium
3 Department Gastroenterology, Maria Middelares Hospital, Ghent, Belgium
4 Department Medical Oncology, Ghent University Hospital and Ghent University, Ghent, Belgium
5 Department Ophthalmology, Maria Middelares Hospital, Ghent, Belgium


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© De Bruyn et al.; Licensee Bentham Open

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/legalcode), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department Ophthalmology, Ghent University Hospital Ghent University, Ghent, Belgium; Tel: +0032 486801592; Fax: 0032 93324963; E-mails: Deborah.debruyn@ugent.be, Simon.vanbelle@ugent.be


Abstract

Objective:

To describe a patient with bilateral multifocal choroidal metastases from an endobronchial carcinoid treated with a somatostatin analogue.

Method:

A 60-year-old woman presenting with photopsia in the left eye underwent an extensive ophthalmic examination, including fluorescein angiography, OCT and ultrasound.

Results:

Fundoscopy revealed a small retinal tear in the left eye, for which she received laser treatment. In addition, choroidal masses were detected in both eyes. Her medical history of a pneumectomy for a bronchial carcinoid six years earlier together with recent elevated chromogranin A blood levels prompted a diagnosis of choroidal metastases. Subsequently, a Gallium-68 DOTANOC positron emitting tomography/computer tomography scan revealed a spinal cord metastasis and mediastinal as well as mesenterial lymph node invasion. Systemic treatment with Sandostatin®, a somatostatin analogue was started. Up until two years after the initial presentation and treatment, these choroidal lesions remained stable without any signs of growth.

Conclusion:

Endobronchial carcinoid tumors have an indolent nature and long-term follow-up is recommended for early detection of metastases. Although treatment with somatostatin analogues rarely induces complete tumor regression, tumor stabilization and prevention of symptoms related to hormone secretion is achieved. This well-tolerated systemic treatment provides a worthy alternative treatment for choroidal metastasis compared to classic radiotherapy without any risk of radiation or laser-related visual loss.

Keywords: Carcinoid tumor, Choroidal metastases, Chromogranine A, Somatostatin analogues.