Adenocarcinoma of the esophagus presenting as choroidal metastasis

Abstract

Adenocarcinoma of the esophagus is an exceedingly rare cause of choroidal metastasis. We report the case of a 48-year-old Caucasian male with a 2-month history of decreased vision and dysphagia. Ophthalmologic examination revealed bilateral choroidal masses and an exudative retinal detachment in the left eye. Gastroduodenoscopy revealed a circumferential mass in the distal esophagus at 30cm extending into and involving the gastroesophageal junction. Endoscopic biopsy disclosed an invasive, poorly differentiated adenocarcinoma. Systemic workup revealed widespread metastatic changes in the pericardium, liver, and left adrenal gland, and a right pleural effusion. The patient's condition rapidly deteriorated, and he passed away 40days after initial presentation. To our knowledge, this represents the first case of choroidal metastasis as the initial manifestation of esophageal adenocarcinoma. © 2011 Copyright the Authors. Journal compilation © 2011, Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.