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Case report
Cancer-associated retinopathy in ampullary pancreatic cancer
  1. Nima Ghadiri1,
  2. Yunfei Yang2 and
  3. Benjamin JL Burton1,3
  1. 1Department of Ophthalmology, James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, UK
  2. 2John Radcliffe Hospital, University of Oxford, Oxford, UK
  3. 3Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
  1. Correspondence to Dr Nima Ghadiri; nimaghadiri{at}nhs.net

Abstract

A 64-year-old woman presented with bilateral visual loss with shimmering photopsias as the only clinical manifestation of an occult pancreatic ampullary adenocarcinoma causing duct dilatation. Abnormal electroretinograms led to suspicion of cancer-associated retinopathy (CAR), and CT of the abdomen showed an underlying pancreatic malignancy, detected with subclinical liver function tests following diagnosis of CAR. Biopsy showed a T2N0M0 ampullary adenocarcinoma. The patient was managed with Whipple’s procedure and adjuvant chemotherapy and has made a good recovery with no progression of her retinopathy. To our knowledge, this is one of the first descriptions of CAR in the context of pancreatic malignancy. It is atypical in its asymmetric presentation and favourable patient outcome. CAR is an important diagnosis to make, as ocular manifestations can be the only indication of an occult malignancy, resulting in a swifter diagnosis and potentially life-saving early intervention.

  • ophthalmology
  • retina
  • pancreatic cancer
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Footnotes

  • NG and YY are joint first authors.

  • Twitter @DrStrangetwit

  • Contributors YY wrote the first draft of the report. NG and BJLB were the main care providers for the patient. NG prepared the report and wrote the final draft for submission. BJLB reviewed the report and approved the article prior to submission.

  • 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 for publication Obtained.

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

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