DOI QR코드

DOI QR Code

Gastric Adenocarcinoma with Systemic Metastasis Involving the Intraocular Choroid and Duodenum

  • Kim, Soon Young (Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Jang, Kee-Taek (Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Jun Haeng (Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2017.03.20
  • Accepted : 2017.04.26
  • Published : 2018.01.30

Abstract

Gastric cancer with double metastasis to the orbit and duodenum is extremely rare. We report the case of a patient with gastric adenocarcinoma who presented with synchronous orbital and duodenal metastases at the time of initial diagnosis. A 60-year-old man presented with a 1-month history of visual disorder and pain in his right eye. He underwent ophthalmological examinations. The biopsy results suggested intraocular metastatic carcinoma. We conducted a systemic evaluation to identify primary malignancy. Finally, a diagnosis of advanced gastric adenocarcinoma with multi-organ metastasis was made. He planned to be treated with systemic chemotherapy.

Keywords

References

  1. Feldman M, Friedman LS, Brandt LJ. Sleisenger and Fordtran's gastrointestinal and liver disease: pathophysiology, diagnosis, management. 9th Ed. Philadelphia (PA): Saunders/ Elsevier; 2010.
  2. Kong BD, Lee TW. Clinical analysis of metastatic intraocular malignancy. J Korean Ophthalmol Soc 1999;40:2928-2934.
  3. Kim HJ, Kang JY. Metastatic gastric adenocarcinoma of the lower eyelid. J Korean Ophthalmol Soc 1995;36:1283-1286.
  4. Kim JH, Yu HG. Clinical characteristics of metastatic choroidal tumors in Korean patients. J Korean Ophthalmol Soc 2008;49:1785-1793. https://doi.org/10.3341/jkos.2008.49.11.1785
  5. Eliassi-Rad B, Albert DM, Green WR. Frequency of ocular metastases in patients dying of cancer in eye bank populations. Br J Ophthalmol 1996;80:125-128. https://doi.org/10.1136/bjo.80.2.125
  6. Shields JA, Shields CL, Brotman HK, Carvalho C, Perez N, Eagle RC Jr. Cancer metastatic to the orbit: the 2000 Robert M. Curts lecture. Ophthal Plast Reconstr Surg 2001;17:346-354. https://doi.org/10.1097/00002341-200109000-00009
  7. Shields CL, Shields JA, Gross NE, Schwartz GP, Lally SE. Survey of 520 eyes with uveal metastases. Ophthalmology 1997;104:1265-1276. https://doi.org/10.1016/S0161-6420(97)30148-1
  8. Tong KA, Osborn AG, Mamalis N, Harrie RP, Call NB. Ocular melanoma. AJNR Am J Neuroradiol 1993;14:1359-1366.
  9. Peyster RG, Augsburger JJ, Shields JA, Hershey BL, Eagle R Jr, Haskin ME. Intraocular tumors: evaluation with MR imaging. Radiology 1988;168:773-779. https://doi.org/10.1148/radiology.168.3.3406407
  10. Goto H. Clinical efficacy of 123I-IMP SPECT for the diagnosis of malignant uveal melanoma. Int J Clin Oncol 2004;9:74-78. https://doi.org/10.1007/s10147-003-0380-2
  11. Amer R, Pe'er J, Chowers I, Anteby I. Treatment options in the management of choroidal metastases. Ophthalmologica 2004;218:372-377. https://doi.org/10.1159/000080939
  12. Gragoudas ES. Current treatment of metastatic choroidal tumors. Oncology (Williston Park) 1989;3:103-110; discussion 111.
  13. Kiratli H, Bilgic S. Solitary choroidal metastasis managed by transpupillary thermotherapy. Eye (Lond) 2000;14 Pt 5:799-800. https://doi.org/10.1038/eye.2000.215
  14. Cusack JC, Tyler DS Jr. Small-bowel malignancies and carcinoid tumors. In: Berger DH, Feig BW, Fuhrman GM, eds. The MD Anderson surgical oncology handbook. Boston (MA): Little, Brown; 1995. p. 142-159.
  15. Barclay TH, Schapira DV. Malignant tumors of the small intestine. Cancer 1983;51:878-881. https://doi.org/10.1002/1097-0142(19830301)51:5<878::AID-CNCR2820510521>3.0.CO;2-V
  16. Michelassi F, Erroi F, Dawson PJ, et al. Experience with 647 consecutive tumors of the duodenum, ampulla, head of the pancreas, and distal common bile duct. Ann Surg 1989;210:544-554; discussion 554-546. https://doi.org/10.1097/00000658-198910000-00015
  17. Kadakia SC, Parker A, Canales L. Metastatic tumors to the upper gastrointestinal tract: endoscopic experience. Am J Gastroenterol 1992;87:1418-1423.
  18. Geboes K, De Jaeger E, Rutgeerts P, Vantrappen G. Symptomatic gastrointestinal metastases from malignant melanoma. A clinical study. J Clin Gastroenterol 1988;10:64-70. https://doi.org/10.1097/00004836-198802000-00014
  19. McNeill PM, Wagman LD, Neifeld JP. Small bowel metastases from primary carcinoma of the lung. Cancer 1987;59:1486-1489. https://doi.org/10.1002/1097-0142(19870415)59:8<1486::AID-CNCR2820590815>3.0.CO;2-W
  20. Loualidi A, Spooren PF, Grubben MJ, Blomjous CE, Goey SH. Duodenal metastasis: an uncommon cause of occult small intestinal bleeding. Neth J Med 2004;62:201-205.

Cited by

  1. Spontaneous rupture of the eyeball due to choroidal metastasis of gastric carcinoma : A case report vol.98, pp.40, 2018, https://doi.org/10.1097/md.0000000000017441