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Surgical Case Reports

, 3:35

First Online: 21 February 2017Received: 29 December 2016Accepted: 18 February 2017

Abstract

BackgroundMetastatic choroidal carcinomas that originated from the gastrointestinal tract are extremely rare. We report a case of suspected solitary choroidal metastasis from gastric adenocarcinoma.

Case presentationThe patient was a 60-year-old man who had undergone laparoscopic distal gastrectomy with D1+ lymphadenecetomy for gastric cancer. The clinical stage was T1bN0M0 TNM classification, but the pathological stage was T4aN0M0 beyond expectation. Adjuvant chemotherapy with oral Tegafur, Gimeracil, Oteracil potassium TS-1 was initiated. But he suddenly complained of decreased visual acuity in his right eye about 8 months later. This was suspected to be caused by choroidal metastasis of gastric adenocarcinoma. Chemotherapy with paclitaxel PTX and intensity-modulated radiotherapy IMRT achieved complete remission and spared the patient from going blind.

ConclusionsThis case demonstrates that we should be aware of the possibility of choroidal metastases, when visual symptoms arise during treatment of gastric cancer.

KeywordsGastric cancer Adenocarcinoma Choroidal metastasis Adjuvant chemotherapy Solitary AbbreviationsI-IMP SPECTN-isopropyl-p-I iodoamphetamine single-photon emission computed tomography

CEACarcinoembryonic antigen

CRTChemoradiation therapy

CTComputed tomography

DMDistal margin

FDG-PETFluorodeoxyglucose-positron emission tomography

HER2Human epidermal growth factor receptor 2

IMRTIntensity-modulated radiotherapy

INFPattern of infiltrating growth

MRIMagnetic resonance imaging

PMProximal margin

por2Non solid type poorly differentiated adenocarcinoma

PTXPaclitaxel

sciScirrhous type

sigSignet-ring cell carcinoma

T1bTumor invades the submucosal layer

T4aTumor exposes on the surface of serosa

TS-1Tegafur, Gimeracil, Oteracil potassium

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Author: Masanari Shimada - Susumu Amaya - Hiroaki Sugita - Yuichiro Furutani - Yoshinori Munemoto - Takeshi Mitsui - Toshiro Tanaha

Source: https://link.springer.com/article/10.1186/s40792-017-0311-5







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