Intraocular metastasis from an anal squamous cell carcinoma: a case report

Anal cancer is a relatively less common gastrointestinal cancer, with common sites of distant metastasis being para-aortic nodes, liver, lungs, and skin. Intraocular metastasis from anal squamous cell carcinoma is an extremely rare occurrence with no reported cases so far.

We present a case of a 70-year-old male with a past medical history of metastatic anal squamous cell carcinoma who presented to the oncology clinic with complaints of sudden onset complete vision loss in his right eye. The patient was then referred to a retina specialist and was found to have a posterior choroidal tumor that raised concerns of a primary uveal melanoma vs. metastatic spread from his known metastatic anal squamous cell carcinoma. Given the severity of his symptoms and diagnostic uncertainty, he underwent right eye enucleation and prosthesis placement. Histopathologic evaluation of the enucleated specimen confirmed the diagnosis of metastatic carcinoma consistent with anal carcinoma.

This case presents the exceptionally rare phenomenon of intraocular metastasis from a primary anal squamous cell carcinoma. Per our literature review, this is the first reported case of such an occurrence, which adds to the clinical complexity of this case in terms of timely diagnosis, effective treatment modalities and prognosis. In these cases, early recognition and diagnosis is critical, as intraocular metastasis significantly affects quality of life as well as overall prognosis. Therefore, through this case report, we aim to highlight the rare intraocular presentation of metastatic anal cell carcinoma, so that clinicians maintain a broad differential diagnosis when evaluating new ophthalmic symptoms in patients with anal cancer.