case_images: PMC10981251_01
case_images: (a) Brain computed tomography demonstrated a fusiform-shaped choroidal tumor to the temporal side of the globe causing exudative retinal detachment, these findings were typically consistent with choroidal metastasis (arrow). Axial brain magnetic resonance imaging, (b) T2 weighted image and (c) diffusion-weighted magnetic resonance imaging, revealed a choroidal mass in the right eye (arrow).
case_images: 10.1177_2050313X241242608-fig1.jpg
case_images: PMC10981251_01_10.1177_2050313X241242608-fig1.jpg
case_images: fig1-2050313X241242608
case_images: After complaining of decreased visual acuity in the right eye, brain imaging was done and showed right choroidal metastasis (Figure 1).
case_images: (a) Computed tomography (CT) scan lung window, marked increase in the sizes and count of the previously mentioned bilateral pulmonary, subpleural, and perifissural nodules, measuring up to 1.3 cm in the left upper lung lobe. (b) Mediastinal window, several enlarged mediastinal lymph nodes (pretracheal, subcarinal), infiltrating the right hilum and encasing the right main bronchus, measuring collectively up to 7.5 cm in maximum axial dimension (Compared to 3.4 cm in the previous exam), with newly noted mild right-sided pleural effusion and mild pericardial effusion. Surgical clips noted that the right upper lobe is suggestive of previous procedure/video-assisted thoracoscopic surgery. (c) Abdominal CT scan showed a marked increase in the size of the previously mentioned peripherally enhancing mass infiltration with necrotic center noted at the central hepatic region adjacent to hepatic venous confluence, measures up to 9 x 7 cm (compared to 5.6 x 4.1 cm in the previous exam) (upper arrow), invading the immediate suprahepatic part of the IVC going with malignant thrombosis (lower arrow), associated with heterogeneous liver enhancement (nut-meg appearance) during the venous phase suggesting hepatic congestion. (d) Newly noted multiple liver metastatic lesions with similar characteristics (multiple arrows).
case_images: 10.1177_2050313X241242608-fig2.jpg
case_images: PMC10981251_01_10.1177_2050313X241242608-fig2.jpg
case_images: fig2-2050313X241242608
case_images: A CT scan and magnetic resonance imaging (MRI) in December 2023 showed disease progression according to response evaluation criteria in solid tumors (RECIST) guideline, with new lung and liver metastatic lesions and malignant thrombosis in the inferior vena cava (IVC) (Figure 2).