CASE OF METASTATIC UROTHELIAL CARCINOMA OF THE RETINA AND VITREOUS

A 55-year-old man with history of urothelial carcinoma of the bladder developed floaters in the right eye 4 years after initial diagnosis. Fundus examination revealed a retinal mass and large mid-vitreous and retrolental cells. Systemic evaluation was negative for metastasis. Vitreous biopsy revealed a high-grade metastatic carcinoma consistent with urothelial carcinoma.
Purpose: To report a rare case of vitreo-retinal metastasis from urothelial carcinoma of the bladder. Methods: Case report. Results: A 55-year-old man with a history of bladder cancer developed atypical vitritis and a white fundus mass. Intravenous fluorescein angiography demonstrated connection between the retinal and tumor vasculature consistent with a retinal malignancy. Cytologic analysis of the vitreous sample revealed large, atypical cells with pleomorphic nuclei, mucin vacuoles, and rare mitotic figures. The cells were immunoreactive for cytokeratin markers AE1/AE3, CK7, and CK20 and the urothelial carcinoma marker GATA3. Review of the patient's initial bladder tumor revealed an anaplastic epithelial neoplasm with dyscohesive cells that appeared histologically identical to those in the vitreous biopsy. Despite external beam radiation therapy, the patient's vision declined and the eye became painful and was ultimately enucleated. Conclusion: Retinal metastasis from systemic adenocarcinoma is an extremely rare occurrence with poor prognosis for vision.