Ryujin Keiichiro, Kawazoe Tetsuro, Sato Shota, Otake Akihiko, Shin Yuki, Tajiri Hirotada, Zaitsu Yoko, Ando Koji, Oki Eiji, Yoshizumi Tomoharu
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan.
Surg Case Rep. 2025;11(1). doi: 10.70352/scrj.cr.25-0317. Epub 2025 Jul 2.
Choroidal metastasis from colorectal cancer is extremely rare, accounting for approximately only 4% of all choroidal metastases. However, with the increasing incidence and improved survival rates of colorectal cancer, the importance of diagnosing and treating ocular metastases is growing. We report a case of choroidal metastasis from colorectal cancer and review the relevant literature.
A 67-year-old man underwent curative surgery and adjuvant chemotherapy for ascending colon cancer. Two years later, pulmonary recurrence was detected and surgically resected. At 2 years and 5 months postoperatively, he developed visual impairment in the left eye, which led to the diagnosis of choroidal metastasis. A combination of systemic chemotherapy and local radiotherapy resulted in tumor shrinkage and relief of ocular pain. With additional local treatments administered in response to subsequent recurrences, the patient achieved long-term survival-5 years and 6 months after surgery and 3 years after the diagnosis of choroidal metastasis. A review of 22 reported cases of choroidal metastasis from colorectal cancer published since 2000 revealed that most patients had multi-organ metastases at the time of diagnosis. The average survival following the diagnosis of ocular metastasis was 10.4 months, indicating a poor prognosis. By contrast, local treatments-such as radiotherapy and intravitreal injections-contributed to symptom relief and the maintenance of quality of life. This case represents a valuable example of long-term survival achieved through combined local therapies.
Although choroidal metastasis from colorectal cancer is rare, clinical management should consider the possibility of ocular involvement. A multidisciplinary approach combining systemic therapy with local treatments is essential for maintaining quality of life and prolonging survival.
结直肠癌的脉络膜转移极为罕见，约占所有脉络膜转移病例的4%。然而，随着结直肠癌发病率的上升和生存率的提高，诊断和治疗眼部转移的重要性日益凸显。我们报告一例结直肠癌脉络膜转移病例并复习相关文献。
一名67岁男性因升结肠癌接受了根治性手术及辅助化疗。两年后，发现肺部复发并进行了手术切除。术后2年零5个月，他左眼出现视力障碍，进而诊断为脉络膜转移。全身化疗与局部放疗相结合使肿瘤缩小，眼部疼痛缓解。针对后续复发进行了额外的局部治疗，患者实现了长期生存——术后5年零6个月，脉络膜转移诊断后3年。对2000年以来报道的22例结直肠癌脉络膜转移病例的回顾显示，大多数患者在诊断时已有多器官转移。眼部转移诊断后的平均生存期为10.4个月，预后较差。相比之下，局部治疗，如放疗和玻璃体内注射，有助于缓解症状并维持生活质量。本病例是通过联合局部治疗实现长期生存的一个有价值的例子。
尽管结直肠癌的脉络膜转移罕见，但临床管理应考虑眼部受累的可能性。将全身治疗与局部治疗相结合的多学科方法对于维持生活质量和延长生存期至关重要。
