Acute Visual Loss as the Presenting Feature of Metastatic Upper Gastrointestinal Cancer-A Rare Case Report ND01-ND03
Dr. Sandra Luz Treviño-Rodríguez,
Av. Francisco I Madero, esquina con Gonzalitos sin numero, Oftalmologia HU, Monterrey, Nuevo León, Mexico.
Choroidal metastases are the most frequent intraocular tumours in adults. Primary tumour sites include lungs in men (68%) and breasts in women (40%). Gastrointestinal cancer is the origin in only 2% of the cases, occurring in women. Only 30% of patients present to the ophthalmologist with no previous history of cancer.
We hereby report the case of a 41-year-old female with no relevant medical history, complaining of sudden-onset blurred vision in the right eye (OD: hand motion), since one day and 20/25 vision in the left eye (OS) due to bilateral, multifocal choroidal metastatic disease. Systemic treatment with carboplatin and paclitaxel was started and the patient refused to undergo orbital External Beam Radiotherapy (EBRT). A follow up of four weeks recorded the rapid progression of bilateral exudative retinal detachment, increase in size of choroidal lesions, visual acuity decline (OD: Light perception, OS: Count fingers, at her last visit), as well as appearance and worsening of systemic symptoms.
This represents a relevant example of a serious underlying multiorgan disease diagnosed after an ophthalmologic examination. Our report highlights the importance of including the differential diagnosis of uveal metastases in patients with suspicious posterior segment lesions despite the absence of systemic symptoms.