This patient with a known history of breast cancer presented with a creamy colored choroidal lesion with central overlying pigmentary changes and scarring in the temporal macula.
Fluorescein angiography showed diffuse subretinal leakage with staining of the overlying scar. OCT scanning showed choroidal thickening with an irregular retinal pigment epithelial contour and overlying subretinal fluid.
The metastatic lesion was treated with localized external beam irradiation, with near immediate tumor regression and decreasing fluid 5 weeks later.
Learning Points:
Although uveal melanoma is the most common primary intraocular malignancy, metastatic choroidal tumors are the most common intraocular malignancies.
Lung and breast cancer are the most common sources.
