Long-Term Survival after Choroidal Metastasis Following Colorectal Cancer Surgery: A Case Report.

INTRODUCTION

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.

CASE PRESENTATION: 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.

CONCLUSIONS

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.