WCLC 2025 - Posters & ePosters-EP.09.17 Permanent Local Control After Orbital Cryoablation for Ocular Metastasis From Lung Cancer

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This report presents two clinical cases of lung cancer patients with choroidal and orbital metastases treated with orbital cryoablation, a novel, eye-preserving approach for radiation-refractory ocular tumors. Choroidal metastases, commonly resulting from lung cancer, threaten vision and quality of life. Standard treatment usually involves systemic therapy combined with external beam radiotherapy, which achieves high tumor control but carries risks such as radiation retinopathy and cataracts, commonly requiring multiple sessions. Enucleation (eye removal) is a last-resort option due to its significant psychological and physical consequences.<br /><br />Case 1 involved a 64-year-old woman with stage IVA lung adenocarcinoma and right orbital metastasis infiltrating the optic nerve, causing exophthalmia and blindness in that eye. Orbital cryoablation was performed under CT guidance, involving freeze-thaw cycles to induce tumor necrosis. The procedure led to 90% tumor debulking, resolution of exophthalmia, preservation of ocular appearance, and avoidance of enucleation. At 18-month follow-up, no recurrence was seen, and the patient reported satisfaction with reduced visual symptoms, though she later died from disease progression elsewhere.<br /><br />Case 2 described a 32-year-old man with rare NUT carcinoma and choroidal metastasis causing vision loss. Following surgery, chemo-immunotherapy, and stereotactic radiotherapy failure, cryoablation was performed similarly to Case 1. Complete tumor response was achieved with scar tissue formation and no recurrence at 27 months. The patient’s headaches and discomfort resolved, his visual appearance was preserved, though he developed a transient corneal ulcer and eventually died from extracerebral disease spread.<br /><br />These cases constitute the first documentation of orbital cryoablation for lung cancer ocular metastases, demonstrating effective local tumor control and permanent ocular preservation. Cryoablation offers a promising alternative to radiotherapy and enucleation, reducing patient distress while maintaining quality of life in selected cases with ocular metastatic tumors.

Asset Subtitle

Nuria Mederos Alfonso

Meta Tag

Speaker Nuria Mederos Alfonso

Topic Metastatic Non-small Cell Lung Cancer – Local Therapies

Keywords

lung cancer

choroidal metastases

orbital metastases

orbital cryoablation

radiation-refractory ocular tumors

eye preservation

tumor necrosis

cryotherapy

ocular tumor treatment

quality of life