J Korean Ophthalmol Soc.  2022 Jan;63(1):107-112. 10.3341/jkos.2022.63.1.107.

An Adenocarcinoma Associated with Bilateral, Diffuse, Uveal Melanocytic Proliferation

• Chung W
• Kim SH
• Choi Y
• Choi SK
• Lee JJ
• Park SW
• Byon IS

• KMID: 2524946
• DOI: http://doi.org/10.3341/jkos.2022.63.1.107

Abstract

Purpose
We report bilateral, diffuse, uveal melanocytic proliferation caused by a stomach adenocarcinoma.
Case summary
A 78-year-old male complained of visual impairment 3 months in duration. He had diabetes and had undergone cataract surgery on both eyes 4 years prior. His best-corrected visual acuity was counting fingers in the right eye and 20/160 in the left eye. Both intraocular pressures were normal. The anterior segments yielded no specific findings. The maculae exhibited multiple, round, patchy, pigmented or depigmented lesions with exudative retinal detachment. Fluorescein angiography revealed multiple hyperfluorescent lesions. Optical coherence tomography revealed that the hyper-reflective exudates lay between the neurosensory retina and the retinal pigment epithelium. We diagnosed bilateral, diffuse, uveal melanocytic proliferation and performed a systemic evaluation. Computed tomography revealed several mass lesions in the lung, stomach, and lymph nodes; these appeared to be malignant. An esophagogastroduodenoscopic biopsy confirmed that the lesions were adenocarcinomas.
Conclusions
A bilateral, diffuse, uveal melanocytic proliferation induced by a primary malignant tumor exhibited multiple, pigmented subretinal exudates associated with exudative macular retinal detachment. In patients with such findings, it is necessary to evaluate the malignant tumor status of remote organs.

Keyword

Adenocarcinoma; Bilateral diffuse uveal melanocytic proliferation; Malignancy; Paraneoplastic syndrome