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Esophageal Metastasis to the Iris Effectively Palliated Using Stereotactic Body Radiation Therapy and Adjuvant Intravitreal Chemotherapy: Case Report and Literature ReviewDhakal S.a · Lema G.M.C.b · DiLoreto Jr D.A.b · Katz A.W.a
Departments of aRadiation Oncology and bOphthalmology, University of Rochester Medical Center, Rochester, N.Y., USA Corresponding Author
Sughosh Dhakal, MD
University of Rochester Medical Center
601 Elmwood Ave., Box 647
Rochester, NY 14642 (USA)
We report a case of isolated iris metastasis from esophageal adenocarcinoma that was successfully managed with local application of stereotactic body radiation therapy (SBRT) and adjunctive intravitreal therapy. A 53-year-old man with locally advanced esophageal adenocarcinoma achieved a complete clinical and radiographic response after surgery and chemotherapy. Four months later, he developed headache and decreased vision and was diagnosed with metastasis to the iris by slit-lamp examination. The decrease in vision was secondary to cystoid macular edema. The metastatic tumor and the patient’s symptoms resolved after treatment with SBRT and intravitreal injections of bevacizumab and triamcinolone. We conclude that SBRT combined with intravitreal chemotherapy is an effective and well-tolerated palliative treatment for metastasis of esophageal adenocarcinoma to the iris.
© 2012 S. Karger AG, Basel