Illustration of iris tumor casting a lung-shaped shadow.

Uncommon Eye Ailment Reveals Hidden Lung Cancer

Mira Elwood in Health & Wellness June 2025 • 4 min read.

"When an Iris Tumor Led to a Shocking Bronchial Carcinoma Diagnosis"

Uveal metastases, the most frequent type of intraocular tumors, often originate from lung cancer, with an incidence ranging from 2% to 6.7%. Metastases to the anterior uvea, specifically the iris and ciliary body, are rare, accounting for 7.2% to 14.1% of intraocular metastases. This case highlights the importance of thorough investigation when unusual symptoms arise.

A 45-year-old chronic smoker presented with decreased visual acuity (4/10). A slit-lamp examination revealed a clear cornea, fine retro-descemet precipitates, and an elevated intraocular pressure of 30 mmHg. A key finding was a neovascularized iris lesion with iridocorneal angle involvement, accompanied by a scleral mass in the superotemporal region. Fundus examination showed a clear vitreous, normal retina, and optic disc. UBM revealed an iris mass invading the angle, ciliary body, and adjacent sclera.

Initial diagnostic considerations included uveal metastasis and achromic iris melanoma. The patient was hospitalized for a comprehensive evaluation to identify a primary cancer. A CT scan of the chest revealed a right upper lobe pulmonary tumor with mediastinal lymph node involvement. Brain MRI showed lesions indicative of secondary spread, while abdominal CT did not reveal any abnormalities. Bronchoscopy with biopsy of the primary lesion confirmed the diagnosis of adenocarcinoma of the lung.

Decoding the Link: How an Eye Exam Can Detect Lung Cancer

Illustration of iris tumor casting a lung-shaped shadow.

This case illustrates a rare presentation of lung cancer, where the initial symptoms manifested in the eye. The iris tumor and associated findings prompted a search for the primary source, eventually leading to the diagnosis of bronchial carcinoma. This highlights the importance of considering metastatic disease in patients presenting with unusual ocular findings, especially those with a history of smoking or other risk factors for cancer.

The following points detail how eye exams can indirectly contribute to early cancer detection:

Comprehensive Eye Exams: Regular eye exams can detect abnormalities not immediately apparent to the patient.
Detailed History: Providing a complete medical history, including smoking habits and family history of cancer, is crucial.
Imaging Techniques: Ultrasound Biomicroscopy (UBM) and other imaging techniques can visualize structures of the eye.
Prompt Referral: Ophthalmologists play a crucial role in recognizing signs.
Interdisciplinary Collaboration: Effective communication and collaboration between ophthalmologists, oncologists, and other specialists are essential for accurate diagnosis and treatment.

Early detection and treatment are crucial for improving outcomes in lung cancer. While ocular metastases are uncommon, this case underscores the importance of vigilance and thorough investigation when faced with atypical presentations. The eye can indeed be a window to systemic disease, prompting timely intervention and potentially life-saving treatment.

A Reminder to Keep Our Eyes Open

This unique case reinforces the importance of comprehensive eye exams and detailed medical histories in detecting underlying systemic diseases, particularly cancer. It highlights the critical role of ophthalmologists in recognizing subtle signs and collaborating with other specialists for timely diagnosis and treatment, ultimately improving patient outcomes.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.jfo.2018.02.009, Alternate LINK

Title: Tumeur Irienne Et De L’Angle Irido-Cornéen Révélant Un Carcinome Bronchique

Subject: Ophthalmology

Journal: Journal Français d'Ophtalmologie

Publisher: Elsevier BV

Authors: S. Leila, M. Yassine, A. Souhaib, A. Houda, H. Ibtissam, M. Abdeljalil

Published: 2018-11-01

Everything You Need To Know

What are uveal metastases, and why are they relevant to this case?

Uveal metastases are the most frequent type of intraocular tumors, often originating from lung cancer, occurring in 2% to 6.7% of cases. The anterior uvea, including the iris and ciliary body, are less common sites for metastases, accounting for 7.2% to 14.1% of intraocular metastases. This occurrence is significant because it highlights how a seemingly unrelated symptom, such as an iris tumor, can be the first indication of a serious condition like bronchial carcinoma. This underscores the importance of comprehensive examinations when unusual symptoms appear.

What is an iris tumor, and why is it significant in this context?

An iris tumor, in the context, is a neovascularized lesion found during a slit-lamp examination. It's significant because this specific finding, accompanied by other ocular observations, led to the diagnosis of bronchial carcinoma. The presence of an iris tumor, along with the iridocorneal angle involvement and a scleral mass, prompted a comprehensive evaluation, including imaging and biopsies, which ultimately revealed the lung cancer. If ignored or misdiagnosed, it could have resulted in delayed detection and treatment of the underlying cancer, which would negatively impact the patient's prognosis.

What is bronchial carcinoma, and why is it important to identify it in this case?

The bronchial carcinoma, diagnosed through a CT scan and bronchoscopy, is the primary cancer discovered in the patient. Its significance lies in its direct correlation with the iris tumor. The iris tumor acted as a visual clue, leading to the investigation that identified the bronchial carcinoma. This connection highlights the importance of considering metastatic disease and recognizing the signs of cancer, especially for those with a history of smoking. The implications of the carcinoma diagnosis include the need for prompt cancer treatment to improve the patient's outcome and potentially save the patient's life.

What is Ultrasound Biomicroscopy (UBM), and why is it important in this case?

Ultrasound Biomicroscopy (UBM) is an imaging technique used in this scenario to visualize the structures of the eye, specifically the iris mass and its invasion of the angle, ciliary body, and adjacent sclera. UBM is significant because it helps the ophthalmologist to evaluate the extent of the tumor and rule out other conditions like achromic iris melanoma. The use of UBM aids in a more precise diagnosis and assists in determining the course of action for treatment. Without UBM, the precise characteristics of the tumor may have been missed, leading to an incorrect diagnosis, and therefore impacting the treatment plan.

Why are comprehensive eye exams so important in this context?

Comprehensive eye exams are crucial because they can detect abnormalities not immediately apparent to the patient. In this case, a routine eye exam uncovered an iris tumor, leading to the diagnosis of bronchial carcinoma. The significance of regular eye exams lies in their ability to identify early signs of systemic diseases. Implications include early detection, timely intervention, and potentially life-saving treatment of cancer. Without thorough eye examinations, the initial clue to the underlying lung cancer might have been missed, leading to delayed treatment and a poorer prognosis.