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

Hiroshi Sashiyama, Yasuhisa Abe, Shin-ichi Sasagawa, Hiroyuki Hanada, Yuko Hatori¹⁾, Mariko Kubota²⁾, Seiichiro Sakao³⁾ and Kenzo Hiroshima⁴⁾

Division of Surgery and Division of Opthalmology¹⁾, Chosei Public Hospital
Department of Opthalmology²⁾, Department of Respirology³⁾ and Department of Diagnostic Pathology⁴⁾, School of Medicine, Chiba University

We report a case of choroidal metastasis from rectal cancer manifesting visual loss as the initial recurrence symptom. A 49-year-old man with progressive vision loss in the left eye referred 15 months after radical rectal cancer surgery was found in funduscopy to have a choroidal tumor with exudative detached retinas and in chest computed tomography (CT) to have small multiple tumors with central cavitations in both lungs. Transbronchial lung biopsy showed adenocarcinoma cells. We diagnosed left choroidal metastasis and multiple lung rectal cancer metastases. Systemic chemotherapy, improved exudative detached retinas and retinochoroidal effusion and the choroidal tumor became smaller and flatten, vision was permanently lost. Lung metastases gradually worsened and the cervical vertebra metastasis appeared. The man died 11 months after the first manifestation of recurrence. Nine cases of choroidal metastasis from colorectal cancer, including our case, have been reported. Because most had multiple organ metastases involving the liver and lung, choroidal metastasis is suspected to be derived secondarily from liver or lung metastases.

Key words
choroidal metastasis, rectal cancer, vision loss

Reprint requests
Hiroshi Sashiyama Department of Surgery, Tsujinaka Hospital Kashiwanoha
148-6 Kashiwanoha Campus, 178-2 Wakashiba, Kashiwa, 277-0871 JAPAN

Accepted
November 18, 2009

To read the PDF file you will need Abobe Reader installed on your computer.