Endoscopy 2018; 50(04): S173
DOI: 10.1055/s-0038-1637564
ESGE Days 2018 ePosters
Georg Thieme Verlag KG Stuttgart · New York

OPHTHALMIC SYMPTOMS AND COLORECTAL CANCER

J Espinel
1   Hospital Universitario de León, Endoscopy, León, Spain
,
M Eugenia Pinedo
2   Hospital Universitario de León, Radiology, León, Spain
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

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Aims:

Venous drainage of the colon is done through the portal system. The first place of hematogenous spread of colorectal cancer (CRC) is usually the liver, followed by lung and bone. Another less frequent site is the brain (0.06 – 3.2%). The ocular metastases of CRC have been described in exceptional cases and, even less, as an initial manifestation of CRC.

Methods:

A 68-year-old male with visual acuity lost and retro-orbital right pain for 2 weeks. In addition, low-grade fever and loss weight of 10 kg in the last month, is present. Several diagnostic imaging tests are performed warning an abscessified (sigmoid) CRC and lung, liver, kidney, adrenal, right ocular (choroidal) metastases (figure).

Results:

A colonoscopy confirmed a stenosing sigmoid CRC (figure). Histology: infiltrating adenocarcinoma. An enteral stent was placed. Evolution: transfer to Palliative Care Unit.

Conclusions:

Choroidal metastases of a CRC is an infrequent event and exceptional as an initial symptom. When it appear, it suggests massive metastatic spread and a grim prognosis.