Successful management of retinal metastasis from renal cancer with everolimus in a monophthalmic patient: a case report

Ismail Essadi, Issam Lalya, Mohamed Kriet, Abdelhamid El Omrani, Rhizlane Belbaraka, Mouna Khouchani

The retina is an uncommon site for metastases, in particular from solid tumors. Some authors have reported a recent increase in the incidence of metastases in infrequent sites, such as brain or bone, probably due to the expanded treatment options and the resulting improved survival. Choroidal metastasis is the most common type of intraocular malignancy. The most common primary sites associated with choroidal metastasis are breast cancer in women and lung cancer in men. Treatment options are limited, but they must be discussed and adapted to the patient profile. We report a case of a 62-year-old Moroccan man with a history of monophthalmitis secondary to a war injury of 30 years' duration. He has been followed for 28 months for metastatic clear-cell renal carcinoma. The first-line treatment was effective for 24 months, before disease progression as retinal metastasis and accentuation of lung metastases. A second-line treatment with everolimus resulted in marked improvement of symptoms, complete recovery of visual function, and partial response in retinal localization. Choroidal metastasis of renal cancer is a rare situation that must be actively sought in order to arrive at a suitable therapeutic approach.