2022 Volume 40 Issue 2 Pages 62-69
Ocular metastasis, particularly iris metastasis, is extremely rare. We report a case of iris metastasis from recurrent ovarian carcinosarcoma. A 63-year-old woman developed peritoneal dissemination and pulmonary metastases, 10 months after complete remission following initial treatment of stage IIIB ovarian carcinosarcoma with primary debulking surgery, followed by paclitaxel/carboplatin chemotherapy. Although she received gemcitabine/carboplatin + bevacizumab (Bev) chemotherapy for platinum-sensitive recurrent cancer, she showed cranial bone metastasis during maintenance Bev therapy. She underwent surgery and radiotherapy for the cranial bone lesions and was subsequently administered systemic liposomal doxorubicin. During suspension of chemotherapy, she visited the ophthalmologist for evaluation of decreased vision, blurring, and pain in her left eye. Slit-lamp examination showed a soft, white irregular tumor in the anterior segment, in her left iris with elevated intraocular pressure only in the left eye. The iris tumor was clinically diagnosed as metastases from ovarian carcinosarcoma. The patient was administered external radiotherapy (30 Gy), which led to tumor regression and gradual improvement in all ocular symptoms. Patients with iris metastasis tend to show extremely poor prognosis; however, prompt treatment can minimize ocular symptoms and prevent blindness to maintain patients' quality of life.
