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Gastric linitis plastica metastatic to the uvea.
A D Liszauer1, J J Wiens, S Brownstein
1Department of Ophthalmology, McGill University, Royal Victoria Hospital, Montreal.
Summary
Gastric adenocarcinoma metastasized to the choroid, causing vision loss and bone metastases. Despite normal carcinoembryonic antigen (CEA) levels, extensive metastatic disease led to patient death.
Area of Science:
- Oncology
- Ophthalmology
- Pathology
Background:
- A 59-year-old man with diffuse, poorly differentiated gastric adenocarcinoma (linitis plastica) underwent total gastrectomy.
- The patient presented with a 5-month history of vision loss in the right eye.
Observation:
- Extensive choroidal tumors were identified as the cause of vision loss.
- Radiologic studies revealed multiple bony metastases.
- Enucleation of the blind, painful right eye was performed.
Findings:
- Pathological examination confirmed massive metastatic mucus-secreting adenocarcinoma in the choroid.
- Immunohistochemical staining showed positive carcinoembryonic antigen (CEA) in differentiated neoplastic cells.
- Plasma CEA levels were normal, despite widespread metastatic disease.
Implications:
- This case highlights a rare presentation of gastric adenocarcinoma metastasis to the choroid.
- Normal plasma CEA levels do not exclude metastatic adenocarcinoma.
- Metastatic gastric cancer can present with ocular and bone involvement, impacting prognosis.