A case of choroidal metastasis from postoperative esophagogastric junctional adenocarcinoma treated with local radiotherapy and systemic chemotherapy with ramucirumab

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  • KATO Chihiro
    Department of Gastrointestinal Surgery, Yokohama Municipal Citizen's Hospital
  • HAYASHI Hiroyuki
    Department of Pathology, Yokohama Municipal Citizen's Hospital
  • FUJII Yoshiro
    Department of Gastrointestinal Surgery, Yokohama Municipal Citizen's Hospital
  • TAKAHASHI Masazumi
    Department of Gastrointestinal Surgery, Yokohama Municipal Citizen's Hospital

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  • 食道胃接合部腺癌術後の転移性脈絡膜腫瘍に対して局所放射線療法と血管新生阻害剤併用全身化学療法が奏効した1例

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Abstract

<p>An 80-year-old male was presented with metamorphopsia of the left eye. Two years ago, the patient was diagnosed with an esophagogastric junction (EGJ) adenocarcinoma with Barrett's esophagus. The patient subsequently underwent esophagectomy with esophagogastrostomy followed by two-field lymphadenectomy. The pathological stage of the tumor was pT1bN0M0, pStage I, tub1-2, ly1, and v0. The human epidermal growth factor receptor type 2 score was 1 plus. The patient experienced an uncomplicated recovery after being discharged from the hospital with no recurrences for the next 28 months. However, follow-up computed tomography performed at the time of the complaint of metamorphopsia of the left eye revealed systemic metastasis. An ophthalmologic evaluation showed an elevated lesion on the left fundus. Finally, brain magnetic resonance imaging indicated choroidal metastases from an EGJ adenocarcinoma. When the left eye was treated with radiotherapy combined with S-1 and oxaliplatin, complete response for choroidal metastasis and partial response for systemic metastasis were achieved. Due to early diagnosis and treatment, the patient's eyesight was salvaged. Furthermore, the availability and contribution of ramucirumab, an angiogenesis inhibitor used as a second line of treatment for advanced gastric cancer, to choroidal metastasis following irradiation-controlled hemorrhagic tumor was explored.</p>

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