Choroidal Metastasis Consistent with Renal Cell Primary

A 57-year-old male presented to clinic with a one-week history of red line in his vision OS. The patient was noted to have a history of left nephrectomy for renal cell carcinoma that was diagnosed after a metastatic lesion was detected in the right upper lung more than three years prior. Ocular examination revealed HM vision in the left eye with no view to the back due to vitreous hemorrhage. Serial B scans demonstrated non-clearing vitreous and subretinal hemorrhage with retinal detachment and concern for a choroidal mass. Enucleation of the left eye was performed to rule out a hemorrhagic intraocular metastasis, and the globe was sent the Florida Lions Ocular Pathology Laboratory for histopathologic analysis. A clear cell choroidal tumor was identified and was consistent with metastasis from a renal cell origin. The tumor was positive for renal cell antigen, cytokeratin, CD10, and PAX8. The patient is doing well two months after enucleation and has not had any recurrence of metastases. 

Presentation Date: 03/19/2020

Issue Date: 08/01/2020