Unilateral retinal detachment as the initial sign of lung adenocarcinoma.

Intraocular metastases, especially to the retina, are uncommon in cancer patients and generally occur in an advanced phase of the disease. In patients with lung cancer, uveal metastases, in particular to the choroid, are the most frequent, and are associated mainly with small cell carcinoma or undifferentiated carcinoma. We report a case of unilateral retinal detachment as first sign of a moderately differentiated lung adenocarcinoma in a 55-year-old non-smoker that was admitted to the hospital for the first time complaining of a sudden visual loss in the superior fields of the left eye. A CT revealed a slight retinal enlargement of the left eye and a solid mass of about 3 centimeters behind the right pulmonary hilus. Bronchoscopic biopsies were performed with diagnosis of adenocarcinoma of the lung. The patient died after 2 months for rapid progression of the disease despite of combined chemotherapy treatment.

Colour-Doppler US evaluation of patients with hypertension and nephropathy.

PURPOSE: The objective of this study was to assess the utility of colour-Doppler ultrasound (CDUS) in the investigation of patients with hypertension and nephropathy and to determine the association between hemodynamically significant stenoses of the renal arteries and abdominal aorta aneurysms (AAA). MATERIALS AND METHODS: Between January 2000 and December 2004, 467 patients (205 women and 262 men, age range 20-96 years) with hypertension and chronic renal failure were referred to us for CDUS evaluation of renal morphology and haemodynamics and identification of haemodynamically significant stenoses of the renal arteries. RESULTS: Of the 467 patients examined by CDUS, 159 (34%) showed no signs of renal artery stenosis (RAS) or nephropathy and were therefore started on medical therapy. The remaining 308 (66%) exhibited signs of haemodynamically significant stenoses of the renal arteries or of nephropathy. AAA was identified in 19 of the 333 patients (5.7%) without haemodynamically significant renal artery stenoses and in 15 of the 134 patients (11.2%) with renal artery stenoses. CONCLUSIONS: Our results confirm the fundamental role of CDUS in the management of patients with suspected or known renovascular disease. The information provided by CDUS on renal hemodynamics is fundamental for a correct clinical approach.