Klin Onkol 2025; 38(1): 52-54. DOI: 10.48095/ccko202552.
Background: Eye tumors are moving targets, but there have been no reports of radiation therapy with real-time monitoring. Case: A 54-year-old woman with metastatic breast cancer was referred for treatment of diplopia due to choroidal metastasis after hippocampal avoiding whole brain radiotherapy. Since visual acuity was preserved and long-term survival was expected, real-time MRI-guided intensity-modulated radiation therapy (36 Gy in 20 fractions) was performed. No adverse events occurred during treatment or during the subsequent one-year follow-up period. The patient‘s diplopia resolved and no choroidal recurrence was observed during the follow-up period. Conclusion: MRI-guided radiation therapy may be a safe and effective treatment for choroidal metastases after hippocampal avoiding whole brain radiotherapy.