Diagnosis of bilateral diffuse uveal melanocytic proliferation unveils primary gastric adenocarcinoma: a case report

Abstract

Background: Bilateral diffuse uveal melanocytic proliferation (BDUMP) is an extremely rare paraneoplastic syndrome, with most cases reported as secondary to female urogenital and male lung malignancies. We reported this case of BDUMP patient whose primary malignancy was gastric adenocarcinoma verified with gastroscopy and subsequent pathological test. Case presentation: A patient complaining blurred vision was suspected of bilateral diffuse uveal melanocytic proliferation (BDUMP), due to bilateral round oval patches at the posterior pole and cardinal signs in retinal angiography. Malignancy screening was suggested, and pathological report from gastroscopy confirmed the primary lesion as gastric adenocarcinoma. The patient chose palliative care due to late stage and unresectable nature of the malignancy. Conclusions: Identifying BDUMP warrants further investigation of a primary malignancy. Our case provided evidence for the link between gastric adenocarcinoma and BDUMP.

Bilateral Diffuse Uveal Melanocytic Proliferation Secondary to Rectal Adenocarcinoma: A Case Report and Literature Review

“…Because systemic CMEP factor produced by systemic malignant diseases is considered to be involved in the pathogenesis of BDUMP, most previous case reports indicated that BDUMP treatment targeted the primary malignancies or metastases, including local resection, radiation, chemotherapy, or various combinations of these approaches ( 3 , 14 ), and that visual symptoms and signs improved after the treatment. In our case, subretinal fluid was totally absorbed and the thickness of the ciliary body and choroid decreased with improvement in the BCVA score 6 months after the rectectomy.…”

“…BDUMP usually occurs in patients with systemic malignant disease, specifically, ovarian carcinoma in women ( 4 , 7 – 10 ) and lung carcinoma in men ( 3 , 4 , 11 – 13 ). Occasionally, BDUMP is associated with gastric adenocarcinoma ( 14 , 15 ), colonic adenocarcinoma ( 16 ), bladder cancer ( 5 , 17 , 18 ), pancreatic carcinoma ( 19 ), or primary vitreoretinal lymphoma ( 20 , 21 ).…”

Rätselhafte bilaterale Aderhautpigmentierungen

“…52 %; 2017), gefolgt von Kolonkarzinom und vom Blasenkarzinom mit jeweils 3 % aller Fälle [3]. Weltweit wurden bisher 2 Fälle einer BDUMP bei Magenkarzinom publiziert [1,5].…”

Ocular Paraneoplastic Syndromes

“…There are no specific ERG symptoms. The reduction of scotopic and photopic a- and b-wave amplitude can be observed [ 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 61 , 62 ].…”

“…The known and previously isolated IgG antibody is named cultured melanocyte elongation and proliferation factor (CMEP). In addition, the HGF has been suggested [ 1 , 57 , 61 , 62 ]. The damage in the RPE layer results in outer blood–retina dysfunction due to RPE malfunctions, and antiretinal autoantigens can subsequently invade the subretinal space [ 48 , 57 , 61 ].…”