폐암에 의한 맥락막 전이암 1예
A Case of Choroidal Metastasis Caused by Lung Cancer
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목적: 과거병력이 없었던 젊은 여자에서의 폐암에 의한 맥락막 전이암 1예를 보고하고자 한다. 증례요약: 31세 여자가 내원 일주일 전부터 시작된 시력저하를 주소로 외래에 내원하였다. 안저검사에서 좌안에 시신경유두 상이측에 융기된 황백색의 맥락막종괴와 장액망막박리가 관찰되었다. 흉부 X-ray에서 비정형폐렴이나 혈행전이를 의심하였고 이에 추가적으로 유방 방사선 촬영, 흉부 및 복부 computed tomography, 척추 magnetic resonance imaging, 기관지경유 폐생검을 시행하였고 폐샘암종으로 진단되었다. 환자는 전신적 항암치료를 시작하였고 한 달 뒤 좌안 시력이 호전되었으며 망막하액과 종괴의 크기가 줄어들었다. 2개월 뒤에 종괴는 사라졌으며 이후에도 재발하지 않았다. 결론: 젊고 과거병력이 없던 여자 환자가 시력저하를 주소로 내원하여 맥락막 전이 소견을 보여 페암을 진단 받은 경우는 흔치 않으며 항암치료만으로 좋은 치료 결과를 얻었기에 보고하는 바이다.
Abstract
Purpose: To report a case of choroidal metastasis caused by lung cancer in a young female who had no history. Case summary: A 31-year-old female presented with decreased vision for 1 week. Fundus examination revealed an orange colored choroidal tumor and serous retinal detachment at superotemporal area of the optic disc on the left eye. On chest X-ray, atypical pneumonia or hematogenous metastasis was shown. Additionally, mammography, chest-abdomen computed tomography, lumbar magnetic resonance imaging, and transbronchial lung biopsy were performed and the patient was finally diagnosed with adenocarcinoma. The patient started systemic chemotherapy and visual acuity improved after 1 month. Tumor size and subretinal fluid also decreased. The tumor disappeared 2 months later and there was no recurrence. Conclusions: There are only few cases in which choroidal metastasis was observed in a young female patient with no history who had decreased visual acuity and was later diagnosed with lung cancer. Authors report this case because a satisfactory result was obtained from chemotherapy alone.
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