Anmeldung zur Tagung
Registration
Grußwort
Invitation
Themen
Topics
Allgemeiner Ablauf
General overview
Wissenschaftliches Programm
Scientific program
Kurse
Courses
Symposien
Symposiums
Frühstück mit Spezialisten
Breakfast with specialists
Arzthelferinnen-Fortbildung
Rahmenprogramm
Social program
DOG Information
DOG Information
Allgemeine Informationen
General Information
Autorenindex
Index of Authors
Ausstellerliste
Exhibitors
Sponsoren
Sponsors
Teilnahmegebühren
Registration fees
Impressum
Solitary iris-metastasis of breast cancer - effective local therapy by electron-radiation
1Martin M., 1Jolevska V., 2Piroth M. D., 2Zierhut D., 1Dithmar S.
1Universitäts-Augenklinik and 2Radiologische Universitätsklinik Heidelberg
Background: The prevalence of intraocular metastases from metastatic
breast-carcinoma is approximately 4-5%. Most of these metastases are located
within the chorioid and occur in widespread metastatic disease. Solitary
metastases of the iris are rare. As far as we know, solitary iris metastases
without any other known manifestation of metastases have not been reported
so far. We report a successful treatment of such an iris metastasis using
electron-radiation.
Case report: A 30-year-old patient presented with an amelanotic
tumor of the iris and the anterior chamber angle of her right amblyopic
eye. The patient had undergone partial excision of her left breast and
lymph node dissection 3 years before. She had also had chemotherapy and
radiation at that time. The iris tumor was considered a metastasis of
breast carcinoma. Extensive staging revealed no further metastases. Therefore,
no systemic treatment was recommended. A fractionated electron-radiation
was performed applying a total dose of 50Gy, fractionated weekly:5x2Gy,
electron-radiation (9MeV). A significant tumor regression was noted at
the end of this therapy. The patient had temporary symptoms of a dry eye.
2 months later a left-sided neck-lymph node metastasis was detected, a
short time later metastases of the lung were also found. Therefore, adjuvant
chemotherapy was started. 13 months after radiation-treatment the iris
metastasis was completely resolved. Until now no signs of cataract have
been detected, visual acuity has remained stable. Tears secretion and
film are normal. The pulmonary metastases are in remission.
Conclusion: The electron-radiation therapy of this iris metastasis
was an effective treatment for preserving visual acuity and ocular function
with tolerable acute toxicity and so far no adverse side effects. The
unusual clinical situation of a solitary iris metastasis as the onset
of metastatic disease allowed temporary observation of the effect of radio-treatment
without the influence of other systemic treatments.