Colorectal cancer may yield metastasis to the choroid. Its management may be challenging, since there is no consensus about treatment. We describe a case of a 70-year-old male with colon cancer who complained of worsening visual acuity of his better-seeing eye to 20/40 secondary to a nonpigmented choroidal mass of medium reflectivity under the inferior temporal arcade and neurosensory foveal detachment. Besides systemic chemotherapy, local treatment with verteporfin photodynamic therapy (vPDT) was performed. After one month, visual acuity improved to 20/25 and subretinal fluid faded. In conclusion, vPDT may be a useful adjuvant treatment modality for choroidal metastasis secondary to colorectal cancer.

/pdf/photodynamic-therapy-of-presumed-choroidal-metastasis-2uejf7heo9.pdf

Photodynamic Therapy of Presumed Choroidal Metastasis Secondary to Colorectal Carcinoma: Literature Review.

Choroidal metastasis from early rectal cancer: Case report and literature review.

Purpose: Colorectal cancers are common and have high mortality, and metastasis is common in follow up. Choroidal metastasis is encountered rarely in rectum cancers, and there is no previous case reported from Turkey. We present our patient who developed choroidal metastasis in his cancer follow-up. Case report: A 74-year-old male patient had undergone operation due to the diagnosis of rectum cancer two years ago, and lung (L) metastasis developed in the 4th month after the adjuvant therapy, but he refused to receive treatment and remained out of follow-up. The patient presented with complaints of decreased vision and light flashes in his eye 21 months after the diagnosis. Management and outcome: Ocular examination revealed a choroidal mass and radiologically choroidal and multiple brain metastases were detected. In our case, whole-brain radiotherapy was administered in the treatment since there were also multiple brain metastases. However, as the ECOG (Eastern Cooperative Oncology Group) performance status of the patient was 3–4 after radiotherapy, systemic treatment was not considered appropriate, and the best supportive care was given. The patient died 2 months after the diagnosis of choroidal metastasis. Conclusion: Currently, there are few suggestions in case reports regarding appropriate treatment approaches for the treatment of rectal cancerchoroidal metastases. Multidisciplinary approaches may be effective for local and systemic treatment. Our case highlights a pathological entity with poor prognosis, which is rarely encountered during the course of rectal adenocarcinomas, and it is the first case of choroidal metastasis reported from our country. However, we believe that it will be important to draw attention to the fact that it is the first reported case of choroid metastasis in a rectal cancer patient with a BRAF V600 E mutation, and patients with BRAF V600 E mutation may develop metastasis to atypical areas due to their aggressive biology.

Rare metastasis in a patient with BRAF-mutated rectal cancer: choroidal metastasis – case report and literature review

Purpose To describe the clinical and histopathological findings of a case of intraocular metastasis due to colorectal adenocarcinoma and to carry out a literature review. Case report A 64-year-old man with a history of tumor resection due to infiltrating colorectal adenocarcinoma three years previously sought ophthalmological care because of severe ocular pain without response to medical treatment and progressive vision loss in the left eye. On ultrasonographic examination, there was a heterogeneous intraocular choroidal tumor, which occupied approximately 40% of the vitreous cavity, as well as peritumoral serous retinal detachment. The patient underwent left eyeball enucleation. The histopathological diagnosis was metastatic tubular adenocarcinoma involving the retina and choroid that partially infiltrated the sclera and the proximal optic nerve. Conclusion The present case highlights a rare pathological entity associated with variable therapeutic schemes and survival times and poor prognosis in patients with metastatic intraocular tumors due to colorectal adenocarcinoma.

/pdf/metastatic-intraocular-tumor-due-to-colorectal-4hvd7749lv.pdf

Metastatic Intraocular Tumor Due to Colorectal Adenocarcinoma: Case Report and Literature Review.

Colorectal cancer ranks third in cancer incidence in the United States, commonly metastasizing to the liver and lungs. Despite its high prevalence, colorectal cancer with intraocular metastasis is exceedingly rare, with only a few cases reported in the literature. This study presents a 58-year-old male, previously treated for rectal adenocarcinoma with liver and lung metastases, who developed choroidal metastasis causing visual impairment. Despite radiotherapy, moderate improvement was observed, and subsequent disease progression led to systemic chemotherapy. Intraocular metastasis, primarily affecting the choroid, is infrequent, often originating from breast and lung cancers. The presented case, originating from primary KRAS wild-type rectal cancer, adds to the limited gastrointestinal-tract-related occurrences. This report underscores the importance of recognizing intraocular metastasis in colorectal cancer, contributing valuable insights for improved understanding and potential guidance for future clinical decisions. Choroidal metastasis carries a poor prognosis, emphasizing the need for tailored management strategies. 

Rectal adenocarcinoma in the eye: An unexpected destination

左眼視力低下を初症状として再発を来した直腸癌の脈絡膜転移症例を経験したので，報告する．症例は49歳の男性で，直腸癌の根治手術15か月後に左眼視力低下を初症状として受診．眼底検査で左眼に，漿液性網膜剥離を伴う脈絡膜腫瘍を認め，胸部CTで両肺に空洞形成を伴う小結節影を多数認めた．経気管支肺生検で腺癌を検出したため，直腸癌の左脈絡膜転移，両側多発性肺転移と診断した．全身化学療法を施行した後，漿液性網膜剥離，網膜下の滲出性変化は改善，脈絡膜腫瘍は縮小し扁平化したが，視力の改善は得られなかった．一方，肺転移は次第に増悪，頸椎転移も出現し，再発後11か月で死亡した．結腸直腸癌の脈絡膜転移報告例は自験例を含め9例とまれであり，報告例は多臓器転移症例が多く，肺，肝転移から2次的に脈絡膜転移を起こす可能性が示唆された．

A Case of Choroidal Metastasis from Rectal Cancer manifesting Visual Loss as the Initial Recurrence Symptom

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A Case of Choroidal Metastasis from Rectal Cancer manifesting Visual Loss as the Initial Recurrence Symptom