Unilateral blindness as a presenting symptom of lung cancer treated with erlotinib

A non-smoker young man presented to the ophthalmologist with loss of vision in his left eye. Clinical work-up revealed metastatic deposits in left retina. Broadened workup also showed metastatic disease in the skull and brain. The search for the primary concluded on the histopathological evidence of Non-Small Cell Lung Carcinoma [NSCLC] in the upper lobe of the left lung. After the diagnosis and ascertaining disease extent, localized radiotherapy to whole skull and retina was given, followed by conventional chemotherapy [Gemcitabine, Carboplatin]. The results of radiation and chemotherapy were not satisfactory, therefore, patient was placed on a new agent [tyrosine kinase inhibitor] Erlotinib [150 mg per day orally in a single dose]. The response was evaluated using clinical and radiological parameters and was found to be satisfactory