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The patient carried an EGFR mutation and initially received afatinib (EGFR TKI), but evidence of progressive disease emerged and cancerous meningitis required a change in therapy. Treatment was switched to erlotinib and bevacizumab. Despite no major change in overall condition, choroidal metastases improved morphologically, and visual function improved bilaterally. The case suggests systemic erlotinib plus bevacizumab may be effective for choroidal metastasis.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/a-case-of-binocular-metastatic-choroidal-tumor-originating-from-pulmonary-adenocarcinoma-successfully-treated-with-molecular-target-therapy/381780/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/a-case-of-binocular-metastatic-choroidal-tumor-originating-from-pulmonary-adenocarcinoma-successfully-treated-with-molecular-target-therapy/381780.png","ImageObject",300,407,{"name":92,"@type":93},"McGucket","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-24",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why was the initial afatinib treatment changed in this patient?","Question",{"text":113,"@type":114},"The patient’s disease course suggested progressive disease despite afatinib, and cancerous meningitis contributed to switching therapy.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What imaging and clinical findings supported the diagnosis of choroidal metastasis?",{"text":118,"@type":114},"Characteristic fluorescein angiography and indocyanine green angiography findings, along with OCT evidence of serous retinal detachment and RPE malformation in both eyes, supported the diagnosis.",{"name":120,"@type":111,"acceptedAnswer":121},"How did the treatment change affect ocular lesions and vision?",{"text":122,"@type":114},"After switching from afatinib to erlotinib and adding bevacizumab, choroidal metastases improved and visual power in both eyes improved, even though the general condition did not change markedly.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},381780,1790619268,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":34,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},1236954412713,"https://us-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","Case Reports in Ophthalmology  \n\n| Case Rep Ophthalmol 2023;14:426–432 |  |\n| --- | --- |\n| DOI: 10.1159/000530130\u003Cbr>Received: November 10, 2022\u003Cbr>Accepted: February 23, 2023\u003Cbr>Published online: September 8, 2023 | © 2023 The Author(s) .\u003Cbr>Published by S. Karger AG, Basel [www.karger.com/cop](www.karger.com/cop) |\n\nThis article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC) ([http://www.karger.com/Services/OpenAccessLicense](http://www.karger.com/Services/OpenAccessLicense)). Usage and distribution for commercial purposes requires written permission.  \nCase Report  \nA Case of Binocular Metastatic Choroidal Tumor Originating from Pulmonary Adenocarcinoma Successfully Treated with Molecular Target Therapy  \nMasataka Yamaokaa Tsutomu Igarashi a, b Naka Shiratori a  \nKeiki Miyaderac Teppei Sugano c Rintaro Noroc Hiroshi Takahashi a  \na Department of Ophthalmology Nippon Medical School Hospital, Tokyo, Japan; b Department of Ophthalmology Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan; c Department of Respiratory medicine Nippon Medical School Hospital, Tokyo, Japan  \nKeywords  \nMetastatic choroid tumors · Lung adenocarcinoma · Bevacizumab  \nAbstract  \nThe occurrence of ocular metastasis from lung cancer is uncommon. In our current case, we report on a 64-year-old male patient found to have metastatic lesions in both choroids after being diagnosed with lung adenocarcinoma. Asthe patient was found to have a mutation in the epidermal growth factor receptor (EGFR), he was treated with the EGFR tyrosine kinase inhibitor (EGFR TKI), afatinib. However, the treatment response suggested the presence of a progressive disease. Thus, due to cancerous meningitis, the patient’s treatment was changed from afatinib to erlotinib, in addition to adding bevacizumab. Although the general condition of the patient did not change, improvement was noted for the choroidal metastasis. Moreover, the drug change also resulted in an improvement of the visual power of both eyes. Therefore, the results for this patient suggest that systemic administration of erlotinib and bevacizumab may be an effective treatment that leads to morphological and functional improvement in choroidal metastasis cases.  \n© 2023 The Author(s) .  \nPublished by S. KargerAG, Basel  \nIntroduction  \nAlthough rare, metastatic choroid tumors are the most common type of intraocular malignancy. The frequency of intraocular metastasis in all patients dying of cancer was reported to be approximately 12%[1]. Lung and breast cancers are two of the predominant tumors that metastasize to the eye [2, 3]. Among the ocular metastases, the choroid is the most commonly affected site [2]. The prognosis for patients with ocular metastases remains unsatisfactory. For  \nCorrespondence to:  \nMasataka Yamaoka, [masataka-yamaoka](masataka-yamaoka@ nms.ac.jp)[@](masataka-yamaoka@ nms.ac.jp)[ nms.ac.jp](masataka-yamaoka@ nms.ac.jp)  \nCase Reports in Ophthalmology  \nCase Rep Ophthalmol 2023;14:426–432 427  \n\n| DOI: 10.1159/000530130 | © 2023 The Author(s) . Published by S. Karger AG, Basel [www.karger.com/cop](www.karger.com/cop) |\n| --- | --- |\n\nYamaoka et al.: Successful Change of Molecular Target Therapy  \nthese patients, life expectancy is reported to be between 2 and 48 months (median 6–9months)[4, 5]. Radiotherapy remains the main type of treatment, as this has been shown to help the majority of patients maintain good vision for as long as they are alive [1]. The development of molecular targeted therapies, such as humanized anti-vascular endothelial growth factor, bevacizumab, and EGFR TKI, has improved the survival rate of patients with advanced lung adenocarcinoma, without substantially increasing the toxicity [6]. In our current case, while choroidal metastasis was found, the disease was progressive and ultimately the patient’s life could not be saved. However, after treatment of the patient with afatinib followed by switching to bev","cbCaigMR63b733bb","https://ap.wps.com/l/cbCaigMR63b733bb","pdf",789296,"English","# Abstract\n# Introduction\n# Case Reports\n## Initial presentation and diagnosis\n## Imaging findings\n## Treatment course and outcomes","[{\"question\":\"Why was the initial afatinib treatment changed in this patient?\",\"answer\":\"The patient’s disease course suggested progressive disease despite afatinib, and cancerous meningitis contributed to switching therapy.\"},{\"question\":\"What imaging and clinical findings supported the diagnosis of choroidal metastasis?\",\"answer\":\"Characteristic fluorescein angiography and indocyanine green angiography findings, along with OCT evidence of serous retinal detachment and RPE malformation in both eyes, supported the diagnosis.\"},{\"question\":\"How did the treatment change affect ocular lesions and vision?\",\"answer\":\"After switching from afatinib to erlotinib and adding bevacizumab, choroidal metastases improved and visual power in both eyes improved, even though the general condition did not change markedly.\"}]","A Case of Binocular Metastatic Choroidal Tumor Originating from Pulmonary Adenocarcinoma Successfully Treated with Molecular Target Therapy | PDF",1790247003,18]