Adenocarcinoma of the esophagus with choroidal metastasis

Successful outcome after radiotherapy in esophageal squamous cell carcinoma with choroidal metastasis: A case report and review of literature

Choroid metastasis from esophageal carcinoma is rare; reports addressing the effectiveness of treatment strategies are limited. We report a case of a 51-year-old man with metastatic esophageal carcinoma who had a 1-month history of blurred vision in his left eye. An ophthalmologic examination revealed a choroidal mass in his left eye. Adjuvant chemotherapy with cisplatin and 5-fluorouracil was initiated; however, visual acuity did not improve. External beam radiotherapy (EBRT) was initiated, resulting in near complete regression of the mass. EBRT is an effective therapeutic modality and should be considered in patients with choroidal metastasis of esophageal carcinoma.

A rare presentation of choroidal metastasis from primary esophageal adenocarcinoma successfully treated with intensity-modulated radiation therapy

Purpose

In this case report, we present a case of choroidal metastasis from a primary esophageal adenocarcinoma that was treated successfully with intensity-modulated radiation therapy.

Observations

A 65-year-old male with known stage IV esophageal adenocarcinoma presented with a central scotoma in his left eye and was ultimately found to have a large choroidal metastatic lesion with overlying subretinal fluid. IMRT was administered over the course of four weeks, resulting in restoration of the patient's vision, regression of the metastatic lesion, and resolution of the subretinal fluid. As of 16 months following completion of radiation, there remains no evidence of choroidal recurrence or radiation-associated ocular complications.

Conclusions

and Importance: To our knowledge, this is the first published case report of a choroidal metastasis from esophageal cancer responding durably to IMRT. IMRT should therefore be considered a viable treatment option for this rare disease.

Choroidal metastasis from esophageal squamous cell carcinoma

We presented a rare case of a sole choroidal metastatic tumor from esophageal squamous cell carcinoma (ESCC) without other organ metastasis in Taiwan. A 43-year-old male with ESCC was referred for a 1-month history of decreased vision in his left eye. A 5.7 mm thick, yellow choroidal tumor occupied posterior pole, featured with pinpoint hyperfluorescence on angiography and subretinal fluid on optical coherence tomography. Positron emission tomography showed a singular hypermetabolic focus in the left eye. The tumor regressed with complete response and the vision preserved after radiation with total 57.60 gray applied by tomotherapy. The gastrointestinal system is the third most common metastatic origin in Taiwan while esophageal cancer metastasizing to choroid is rare. The discrepancy between the high prevalence of primary ESCC and the rareness of choroidal metastasis from ESCC is undetermined.

Choroidal metastasis from granulocyte colony-stimulating factor-producing esophageal squamous cell carcinoma: a case report

Granulocyte colony‐stimulating factor (G‐CSF)‐producing esophageal squamous cell carcinoma (ESCC) is rare. Esophageal cancer is a highly aggressive disease and often spreads hematogenously; however, choroidal metastases are rarely seen. This report detailed an extremely rare case of G‐CSF‐producing ESCC with choroidal metastasis.

Iris metastasis from esophageal squamous cell carcinoma: A case report

Carcinoma metastatic to the eye is a rare condition, typically associated with a poor prognosis. Breast and lung cancers are the most common sources of intraocular metastases, and the majority of metastatic lesions involve the posterior uvea, with <8% of reported cases arising in the iris. Intraocular metastasis as the presenting form of esophageal carcinoma is highly uncommon. In the present report, a rare case of metastatic iris tumor resulting from esophageal squamous cell carcinoma is discussed. A 64-year-old patient presented with a progressively distending pain in the right eye, with associated blurred vision. Local and systemic evaluation was performed, followed by treatment. Multiple examinations identified a neoplasm in the right iris and postoperative pathology revealed that the iris lesion was a metastasis of esophageal squamous cell cancer origin. The patient was treated with adjuvant radiation. To the best of our knowledge, this was only the second reported case of esophageal squamous cell carcinoma metastasizing to the iris.

Bilateral choroidal metastases from primary esophageal melanoma: a rare case

PURPOSE

The purpose of this case report is to report a rare, bilateral, choroidal metastases from a primary esophageal melanoma.

CASE REPORT

A 44-year-old white female presented to the ocular oncology clinic in February 2010 on urgent referral from her ophthalmologist for evaluation of an elevated mass in each eye. The patient presented with best-corrected visual acuities of 20/25 in both eyes. Fundus examination displayed creamy white choroidal infiltrates located in the superior temporal arcade of the right eye and temporally in the left eye. The patient was diagnosed with bilateral choroidal metastatic melanoma from known primary esophageal melanoma. External beam radiation therapy was administered and complete resolution of the lesions occurred. Final visual outcome was 20/20 in both eyes. Nine months after diagnosis of choroidal metastases, the patient died from complications related to the extensive systemic metastatic involvement.

CONCLUSIONS

Choroidal metastases are the most common intraocular malignancy. However, metastatic melanoma is a rare finding and has only been reported from cutaneous and primary choroidal melanoma. Therefore, to the best of the authors' knowledge, this is the first reported case of bilateral choroidal metastasis from a primary esophageal malignant melanoma.

Adenocarcinoma of the esophagus presenting as choroidal metastasis

Adenocarcinoma of the esophagus is an exceedingly rare cause of choroidal metastasis. We report the case of a 48-year-old Caucasian male with a 2-month history of decreased vision and dysphagia. Ophthalmologic examination revealed bilateral choroidal masses and an exudative retinal detachment in the left eye. Gastroduodenoscopy revealed a circumferential mass in the distal esophagus at 30 cm extending into and involving the gastroesophageal junction. Endoscopic biopsy disclosed an invasive, poorly differentiated adenocarcinoma. Systemic workup revealed widespread metastatic changes in the pericardium, liver, and left adrenal gland, and a right pleural effusion. The patient's condition rapidly deteriorated, and he passed away 40 days after initial presentation. To our knowledge, this represents the first case of choroidal metastasis as the initial manifestation of esophageal adenocarcinoma.

Iris metastasis of esophageal cancer

Ocular metastasis in patients with esophageal cancer is quite rare. Several cases have been reported in the literature, but no successful treatments for such metastases have ever been described. We herein report a case of esophageal cancer in which the ocular metastasis was controlled by systemic chemotherapy.

Isolated choroidal metastasis from primary adenocarcinoma of the distal esophagus: a case report

We present a case of a 41-year-old male patient who, 1 year after transhiatal esophagectomy and transmediastinal gastroplasty for an adenocarcinoma of the distal esophagus, presented with an isolated metastasis in the choroids of the left eye. Because of pains caused by secondary glaucoma, enucleation of the left eyeball had to be performed as the treatment of choice. At 1 year after surgery of the eye, the secondaries in both adrenal glands were revealed. Despite the applied chemotherapy, the patient died with signs of generalized disease 3 years after the initial surgery.