A Case of Choroidal Metastasis Determined to be Hepatocellular Carcinoma

An 80-year-old monocular patient presented with progressively worsening vision in his right eye. He was noted to have choroidal metastasis in this eye and was subsequently admitted for a thorough work-up per oncology to find a primary tumor. After whole body imaging was completed, he was found to have hepatocellular carcinoma proven histopathologically from liver biopsy. He was treated with external beam radiation therapy and his visual acuity and imaging at one-month follow-up showed no improvement. This case highlights the interesting relation between two highly vascular organs – the liver and the choroid - and the diagnostic challenge that exists with choroidal metastases from an unknown primary tumor. It also underscores the need for additional studies to determine whether primary tumor type affects therapeutic management and prognosis.