Uterine papillary serous carcinoma metastatic to the choroid.

Purpose: To report an unusual case of choroidal metastasis from uterine papillary serous carcinoma presenting as a choroidal hemorrhage.

Methods: A 70-year-old woman with a history of Stage IV endometrial cancer presented with sudden loss of vision and pain behind the right eye. Clinical examination revealed a choroidal hemorrhage with retinal detachment. The clinical findings, results of imaging studies, and pathologic findings are described.

Results: The patient underwent drainage of the choroidal hemorrhage but developed a painful, blind eye resulting from secondary glaucoma that was refractory to maximal medical therapy. Examination of the drained choroidal fluid showed no malignant cells. The patient elected for enucleation of the affected eye, and histopathologic analysis was consistent with uterine papillary serous carcinoma metastatic to the choroid. The patient tolerated the procedure well. However, she entered hospice shortly after surgery to receive palliative care for her metastatic disease.

Conclusion: Rare cases of uterine cancer metastasizing to the uvea have been reported. To our knowledge, this is the first case of uterine papillary serous carcinoma with uveal metastasis. Metastatic disease involving the uvea should be considered in the differential diagnosis for a patient presenting with pain and sudden loss of vision, particularly when the patient has a known primary malignancy. Histopathology and cytology can assist in identifying a uveal mass as metastatic.