Iris metastasis as the first sign of small-cell lung carcinoma with metastatic involvement of the mediastinum

We present the case of small-cell lung carcinoma metastatic to the iris, the course of the disease and management options. A 69-year-old female was diagnosed with a solid, amelanotic iris mass in her left eye. Differential diagnostics and ancillary tests subsequently led to the diagnosis of disseminated small-cell lung carcinoma. Systemic chemotherapy was indicated after fine needle biopsy verification of metastatic lung cancer. Iris metastasis responded well to the chemotherapy, its regression was observed and secondary open-angle glaucoma was controlled as well. Good visual functions were preserved during the treatment. Metastatic carcinoma of the iris may be the first sign of disseminated malignant disease. Small-cell lung carcinoma iris metastasis can be treated with chemotherapy. This treatment preserved visual functions, which enhanced the patient's quality of life.