Multimodal Imaging in Choroidal Metastases of Pancreatic Adenocarcinoma: A Case Report

Introduction: Choroidal metastases are malignant intraocular tumours that typically occur in the advanced stages of cancer. In rare instances, they may serve as the first indicators of cancer or a recurrence of the disease. Pancreatic adenocarcinoma is an exceptionally uncommon cause of choroidal metastases. Diagnosing choroidal metastases can be challenging and relies on findings from various modalities, including clinical assessments, ultrasonography, tomography, angiography, and ocular magnetic resonance imaging. Objective: The objective of this study is to diagnose choroidal metastasis and exclude differential diagnoses through a range of complementary examinations. Observation: We report the case of a 46-year-old man who had experienced weight loss for three months and jaundice for one month. He subsequently presented with an acute loss of vision in his right eye, which persisted for one week. Ophthalmological examination revealed bilateral choroidal masses accompanied by an exudative retinal detachment in the right eye. An endoscopic biopsy confirmed the diagnosis of pancreatic adenocarcinoma. Further systemic evaluations revealed multiple metastatic nodules in the brain, lungs, and liver. Consequently, systemic palliative chemotherapy was initiated, while specific ophthalmological treatment was deemed inappropriate given the patient's condition. Conclusion: Choroidal metastasis from pancreatic adenocarcinoma is extremely rare, with very few cases reported in the literature to date.