Photodynamic Therapy of Presumed Choroidal Metastasis Secondary to Colorectal Carcinoma: Literature Review

Abstract

Colorectal cancer may yield metastasis to the choroid. Its management may be challenging, since there is no consensus about treatment. We describe a case of a 70-year-old male with colon cancer who complained of worsening visual acuity of his better-seeing eye to 20/40 secondary to a nonpigmented choroidal mass of medium reflectivity under the inferior temporal arcade and neurosensory foveal detachment. Besides systemic chemotherapy, local treatment with verteporfin photodynamic therapy (vPDT) was performed. After one month, visual acuity improved to 20/25 and subretinal fluid faded. In conclusion, vPDT may be a useful adjuvant treatment modality for choroidal metastasis secondary to colorectal cancer.

Bacillary Layer Detachment (BALAD) in Macular Choroidal Metastasis of a Low-grade Rectal Adenocarcinoma

“…Adenocarcinoma is the most common histological type of colorectal cancer (95%), 20% of them being metastatic at diagnosis. Ocular metastases are most frequently choroidal, are either unilateral or bilateral, and represent approximately 4% of the colorectal cancer metastasis sites 4 . The age of our patient lies within the younger range (30 – 79 years) of these patients, of whom about two-thirds are men, with an average age of 54 years 5 .…”

Choroidal Metastasis as the Initial Presentation of Rectal Adenocarcinoma

“…The current literature contains few recommendations regarding the appropriate treatment of choroidal metastasis from colorectal cancer, but an aggressive multidisciplinary approach is recommended. Treatment options for symptomatic choroidal metastases depend on systemic status and staging of the metastatic disease, and options include observation, systemic chemotherapy, radiotherapy, intravitreal bevacizumab therapy or even enucleation for blind and painful eyes harbouring metastatic tumours [3,4] . Our patient was started on concurrent chemoradiation with FOLFOX but was lost to follow-up after three cycles of radiation and hence his ultimate ou tcome is unknown.…”

“…Photodynamic therapy is a non-thermal laser modality that can be used. It works through induction of necrosis and apoptosis, damage to intratumoral vasculature and a local inflammatory reaction [4] . Bevacizumab is a recombinant humanized antibody against all isoforms of VEGF-1.…”

Role of Metastasis Suppressor KAI1/CD82 in Different Cancers

“…Colorectal carcinoma (CRC) consists of the development of cancer from colon or rectum [ 33 ]. CRC ranks third among malignancies worldwide and is the second leading cause of cancer-related deaths [ 34 ].…”