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Retinal metastasis presenting as a retinal hemorrhage in a patient with adenocarcinoma of the cecum.

In contrast to choroidal metastases, which are the most common malignant intraocular neoplasms in adults, metastases confined to the retina are extremely rare. The colon is an infrequent source of metastatic carcinoma to the retina. To our knowledge, there are 2 other reported cases of metastatic adenocarcinoma of the retina that potentially derive from adenocarcinoma of the colon. In 1 case, the patient had Muir-Torre syndrome with sebaceous adenomas of the face and neck, uterine leiomyoma, adenocarcinoma of the breast, colonic adenocarcinoma, keratoacanthoma of the eyelid and squamous cell carcinoma of the forehead. In the same case, histopathologic analysis of the retinal tumor had occurred following enucleation of a painful eye. Although the retinal lesion was an adenocarcinoma, it had clear cell features that were lacking in the adenocarcinoma of the colon. During the course of care, the patient had also undergone previous mastectomy for the adenocarcinoma of the breast and excision of the sebaceous adenomas, but the samples were reported to be unavailable for review. As such, the source of the retinal metastasis remained unverified. The second case was described by Kennedy et al as a patient with an adenocarcinoma of the rectosigmoid region who underwent enucleation following metastasis to the macula. We describe a patient with an adenocarcinoma arising in the cecum. He developed a solitary retinal metastasis located along the inferior temporal arcade that was excised. The initial examination was unusual, as the appearance was that of a retinal hemorrhage. The resulting histopathology was consistent with the primary tumor.