Choroidal metastasis from hepatocellular carcinoma, diagnosed by fine needle aspiration biopsy and treated by iodine-125 brachytherapy

To report a rare case of choroidal metastasis from hepatocellular carcinoma. A 63-year-old man with known hepatocellular carcinoma (HCC) and treated clavicular metastasis noted reduced visual acuity in the right eye. He was found to have an amelanotic choroidal tumor measuring 18 x 14 x 9.3 mm and with retinal detachment. Fine needle aspiration biopsy confirmed metastatic HCC. The choroidal metastasis was treated with 5 days of iodine-125 plaque brachytherapy (3500 cGy to apex). Tumor regression to 2.6 mm thickness with resolution of retinal detachment and preservation of visual acuity at 20/40 at the 4-month follow-up was documented. HCC metastasis to the choroid can be treated with focal plaque brachytherapy, with preservation of vision and quality of life.