Fig. 20. Metastatic lung carcinoma to choroid exhibiting apical nodular eruption of tumor through Bruch's membrane. A. Yellow-white choroidal mass with tan apical nodular eruption through Bruch's membrane, blots of subretinal blood on the surface of the nodule, and an associated secondary retinal detachment. B-D. Fluorescein angiogram of lesion. B. Venous phase frame showing generalized hypofluorescence of choroidal mass except for focal deep intralesional smudgy hyperfluorescent figures. C. Late venous phase frame showing sustained hypofluorescence of choroidal mass, increased hyperfluorescence of smudgy intralesional foci, and hyperfluorescent subretinal fluid along the superior margin of the mass. D. Late-phase frame showing persistent hypofluorescence of most of the apical nodule, expanded smudgy hyperfluorescence of several foci within the lesion, and intense staining of the associated subretinal fluid.