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To the Editor.
—In a recent clinicopathologic case report, "Metastatic Carcinoma Simulating a Postoperative Endophthalmitis" (Arch Ophthal83:59-60,1970), Levine and Williamson described a patient who developed a hypopyon one month after cataract extraction. Three months later, when the patient died, metastatic bronchogenic carcinoma in the iris was noted.The article left several important questions unanswered:
Was the preoperative medical review of systems positive for respiratory or neurological complaints, a history of recent weight loss, or other symptoms suggestive of metastatic disease?
Did the preoperative physical examination reveal any evidence of pulmonary or metastatic disease?
Were the preoperative laboratory examinations suggestive of an ocult malignancy (anemia, abnormal liver function tests, elevated serum calcium level, etc)?
What did the routine preoperative chest roentgenogram reveal?
At the time the hypopyon was noted, were cervical or other lymph nodes palpable? What was the extent of the primary tumor?
What other organs were involved
Bullock JD. METASTATIC CARCINOMA. Arch Ophthalmol. 1970;84(2):236. doi:10.1001/archopht.1970.00990040238021
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