Metastatic esophageal adenocarcinoma presenting in the iris

To report a case of metastatic esophageal adenocarcinoma presenting as an acute primary iris tumor of unknown origin.

Interventional, clinicopathologic case report.

A 47-year-old healthy man sought treatment for a three-week history of a progressively enlarging red spot on the left iris. Presentation, local and systemic evaluation, and treatment are described.

Iris biopsy revealed the lesion represented metastasis, and a systemic evaluation later revealed the primary source as esophageal adenocarcinoma. The patient began systemic chemotherapy.

Metastatic iris lesions can have atypical presentations. Tissue biopsy, tumor antigens, and a thorough systemic evaluation are crucial in identification of primary tumors in cases of unknown metastatic origin.