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Rare disease
CASE REPORT
Rectal adenocarcinoma: rare metastasis to the optic nerve
  1. Omer Jamall1,
  2. Korina Theodoraki1,
  3. Sepideh Amin2,3,
  4. David Verity4 and
  5. Adam Bates1
  1. 1 Department of Ophthalmology, Maidstone Hospital, Maidstone, UK
  2. 2 Department of Ophthalmology, UCL Institute of Ophthalmology, London, UK
  3. 3 Department of Ophthalmology, University College London Hospitals NHS Foundation Trust, London, UK
  4. 4 Department of Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, UK
  1. Correspondence to Adam Bates, adambates{at}nhs.net

Abstract

We present the first reported case of histologically proven colorectal adenocarcinoma with metastatic spread to the optic nerve. A 49-year-old man, with a known history of rectal adenocarcinoma, presented with progressive loss of vision in his left eye. On presentation, he had no perception to light in his left eye and Snellen acuity of 6/36 in the right eye. Fundus examination showed a left globally swollen optic nerve with a few flame-shaped haemorrhages. A gadolinium-enhanced MRI scan demonstrated abnormal thickening of the anterior and mid-section of the optic nerve with high signal on STIR and postgadolinium enhancement. Optic nerve biopsy confirmed the presence of epithelial adenocarcinoma compatible with metastasis of gut origin. The patient died within 4 months of presentation.

  • ophthalmology
  • colon cancer
  • head and neck cancer

https://doi.org/10.1136/bcr-2018-228090

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    Footnotes

    • Contributors OAJ: Planning, conduct, acquisition of data, analysis and interpretation of data, write up. Korina Theodoraki: Acquisition of data, analysis and interpretation of data, write up. AB: Planning, conception and design, analysis and interpretation of data, revising write up. SA: Analysis and interpretation of data, revising write up. DV: Analysis and interpretation of data, revising write up.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Next of kin consent obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.