Lung adenocarcinoma with metastasis to the vitreous – A case report and review of literature

Non-small cell lung carcinoma (NSCLC) is a leading cause of cancer-related death, and some patients can present with advanced metastatic disease mostly involving the brain, bones, liver, or adrenal glands. Eye is an extremely rare site of metastasis. We present a case of a patient with NSCLC with rare vitreal metastasis. A 70-year-old female was admitted to the hospital with hypertensive crisis and on further imaging, was found to have a 4.5 cm spiculated nodule in the upper lobe of the right lung. Outpatient bronchoscopy and biopsy confirmed lung adenocarcinoma and she underwent right upper lobe wedge resection and mediastinal lymph node dissection. The surgical staging for the cancer was pT1a pN0, placing her in stage IA. The cells from the tumor were positive for epidermal growth factor receptor (EGFR) mutations: G719X and S768I. Unfortunately, six months later, she started to experience decreased visual acuity and floaters. Vitrectomy was done, and cytology showed atypical cells concerning for malignancy. These malignant cells were also positive for the same mutations as the lung adenocarcinoma. She was then treated with EGFR inhibitor afatinib to prevent relapse. She currently remains asymptomatic