I have just received a patient with widespread mucinous adeno of unclear etiology. CT C/A/P negative, PET next week. Bizarre story - compression fx first week of June in a lady with osteoporosis, DJD, and 2 other compression fractures. Bx before vertebroplasty AND bone scan of the spine were negative. Fast forward 6 weeks and she has diffuse bone pain & rapidly deteriorating vision. She has widespread bony disease on bone scan, biopsy of a hip met shows mucinous adeno, and she has bilateral choroid mets L>R with early retinal detachments. Mammogram negative, but she does have a 1 cm left axillary node that's firm. Gammaknife was recommended to her family, but I suspect the doctor who recommended this didn't know the extent of her disease. My plan is to scan her brain today - if brain mets, whole brain EBRT to 30 to include the posterior 1/2 of both eyes. If no brain mets, 40 Gy in 20 fx to the posterior 1/2 of the eyes. There are limited data, but I can't find anything to suggest this is a bad plan. Any thoughts would be greatly appreciated! Thanks.