Iris metastasis from large-cell neuroendocrine carcinoma in a patient with double primary malignancies: A rare presentation

Iris metastasis is relatively rare in patients with ocular metastasis. We describe a rare case of iris metastasis from double primary malignancies and the challenges in managing its complications. A 62-year-old gentleman presented with right painful red eye associated with photophobia and blurred vision for a month. He had a history of treated diffuse large B cell lymphoma, underwent surgery with adjuvant chemotherapy, and was in remission for the past 10 years. Subsequently, he was diagnosed with Stage IV large cell neuroendocrine carcinoma 2 years ago, under radiographic surveillance after completed 6 cycles of chemotherapy. Eye examination showed an inferior iris mass and progressively high intraocular pressure. The patient was treated conservatively for the refractory secondary glaucoma. Unfortunately, he succumbed to disease 4 months after the diagnosis of ocular metastasis. To the best of our knowledge, this was the only reported case of iris metastasis from multiple primary malignancies.