Cancer-associated retinopathy in ampullary pancreatic cancer
A 64-year-old woman presented with bilateral visual loss with shimmering photopsias as the only clinical manifestation of an occult pancreatic ampullary adenocarcinoma causing duct dilatation. Abnormal electroretinograms led to suspicion of cancer-associated retinopathy (CAR), and CT of the abdomen...
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| Veröffentlicht in: | BMJ case reports 2019-11, Vol.12 (11), p.e231444 |
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| creator | Ghadiri, Nima Yang, Yunfei Burton, Benjamin JL |
| description | A 64-year-old woman presented with bilateral visual loss with shimmering photopsias as the only clinical manifestation of an occult pancreatic ampullary adenocarcinoma causing duct dilatation. Abnormal electroretinograms led to suspicion of cancer-associated retinopathy (CAR), and CT of the abdomen showed an underlying pancreatic malignancy, detected with subclinical liver function tests following diagnosis of CAR. Biopsy showed a T2N0M0 ampullary adenocarcinoma. The patient was managed with Whipple’s procedure and adjuvant chemotherapy and has made a good recovery with no progression of her retinopathy. To our knowledge, this is one of the first descriptions of CAR in the context of pancreatic malignancy. It is atypical in its asymmetric presentation and favourable patient outcome. CAR is an important diagnosis to make, as ocular manifestations can be the only indication of an occult malignancy, resulting in a swifter diagnosis and potentially life-saving early intervention. |
| doi_str_mv | 10.1136/bcr-2019-231444 |
| format | Article |
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Abnormal electroretinograms led to suspicion of cancer-associated retinopathy (CAR), and CT of the abdomen showed an underlying pancreatic malignancy, detected with subclinical liver function tests following diagnosis of CAR. Biopsy showed a T2N0M0 ampullary adenocarcinoma. The patient was managed with Whipple’s procedure and adjuvant chemotherapy and has made a good recovery with no progression of her retinopathy. To our knowledge, this is one of the first descriptions of CAR in the context of pancreatic malignancy. It is atypical in its asymmetric presentation and favourable patient outcome. CAR is an important diagnosis to make, as ocular manifestations can be the only indication of an occult malignancy, resulting in a swifter diagnosis and potentially life-saving early intervention.</description><identifier>ISSN: 1757-790X</identifier><identifier>EISSN: 1757-790X</identifier><identifier>DOI: 10.1136/bcr-2019-231444</identifier><identifier>PMID: 31712238</identifier><language>eng</language><publisher>England: BMJ Publishing Group Ltd</publisher><subject>Adenocarcinoma - complications ; Ampulla of Vater ; Bile ; Cancer ; Case reports ; Cataracts ; Endoscopy ; Eye surgery ; Female ; Field study ; Humans ; Immunoglobulins ; Middle Aged ; ophthalmology ; Pancreatic cancer ; Pancreatic Neoplasms - complications ; Photoreceptors ; retina ; Retinal Diseases - etiology ; Unexpected Outcome (Positive or Negative) Including Adverse Drug Reactions ; Vision Disorders - etiology</subject><ispartof>BMJ case reports, 2019-11, Vol.12 (11), p.e231444</ispartof><rights>BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2019 BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ. 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b492t-57d2ea24885df68bf69c0576c1fc242d220d2f2cb9f353113205544837443d533</citedby><cites>FETCH-LOGICAL-b492t-57d2ea24885df68bf69c0576c1fc242d220d2f2cb9f353113205544837443d533</cites><orcidid>0000-0001-5591-2419 ; 0000-0002-7130-9801</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6855908/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6855908/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27903,27904,53770,53772</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31712238$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ghadiri, Nima</creatorcontrib><creatorcontrib>Yang, Yunfei</creatorcontrib><creatorcontrib>Burton, Benjamin JL</creatorcontrib><title>Cancer-associated retinopathy in ampullary pancreatic cancer</title><title>BMJ case reports</title><addtitle>BMJ Case Rep</addtitle><addtitle>BMJ Case Rep</addtitle><description>A 64-year-old woman presented with bilateral visual loss with shimmering photopsias as the only clinical manifestation of an occult pancreatic ampullary adenocarcinoma causing duct dilatation. Abnormal electroretinograms led to suspicion of cancer-associated retinopathy (CAR), and CT of the abdomen showed an underlying pancreatic malignancy, detected with subclinical liver function tests following diagnosis of CAR. Biopsy showed a T2N0M0 ampullary adenocarcinoma. The patient was managed with Whipple’s procedure and adjuvant chemotherapy and has made a good recovery with no progression of her retinopathy. To our knowledge, this is one of the first descriptions of CAR in the context of pancreatic malignancy. It is atypical in its asymmetric presentation and favourable patient outcome. CAR is an important diagnosis to make, as ocular manifestations can be the only indication of an occult malignancy, resulting in a swifter diagnosis and potentially life-saving early intervention.</description><subject>Adenocarcinoma - complications</subject><subject>Ampulla of Vater</subject><subject>Bile</subject><subject>Cancer</subject><subject>Case reports</subject><subject>Cataracts</subject><subject>Endoscopy</subject><subject>Eye surgery</subject><subject>Female</subject><subject>Field study</subject><subject>Humans</subject><subject>Immunoglobulins</subject><subject>Middle Aged</subject><subject>ophthalmology</subject><subject>Pancreatic cancer</subject><subject>Pancreatic Neoplasms - complications</subject><subject>Photoreceptors</subject><subject>retina</subject><subject>Retinal Diseases - etiology</subject><subject>Unexpected Outcome (Positive or Negative) Including Adverse Drug Reactions</subject><subject>Vision Disorders - etiology</subject><issn>1757-790X</issn><issn>1757-790X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkdtLwzAYxYMobsw9-yYFX0Spy7VpQQQZ3mDgi4JvIU1T19E2NWmF_femds4LCOYlgfy-wznfAeAQwXOESDRLlQ0xREmICaKU7oAx4oyHPIHPu9_eIzB1bgX98VhMyT4YEcQRxiQeg4u5rJW2oXTOqEK2OgusbovaNLJdroOiDmTVdGUp7TpoPGq1bAsVqI-pA7CXy9Lp6eaegKeb68f5Xbh4uL2fXy3ClCa4DRnPsJaYxjHL8ihO8yhRkPFIoVxhijOMYYZzrNIkJ4z4aBgyRmlMOKUkY4RMwOWg23RppTOl69bKUjS2qLwvYWQhfv7UxVK8mDcRxYwlMPYCJxsBa1477VpRFU5pH6vWpnOiX6DfD8c9evwLXZnO1j5eTxFMkbfsqdlAKWucszrfmkFQ9OUIX47oyxFDOX7i6HuGLf9ZhQdOByCtVv9QO_uCtwb_ot8B5Hejzw</recordid><startdate>20191110</startdate><enddate>20191110</enddate><creator>Ghadiri, Nima</creator><creator>Yang, Yunfei</creator><creator>Burton, Benjamin JL</creator><general>BMJ Publishing Group Ltd</general><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-5591-2419</orcidid><orcidid>https://orcid.org/0000-0002-7130-9801</orcidid></search><sort><creationdate>20191110</creationdate><title>Cancer-associated retinopathy in ampullary pancreatic cancer</title><author>Ghadiri, Nima ; 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Abnormal electroretinograms led to suspicion of cancer-associated retinopathy (CAR), and CT of the abdomen showed an underlying pancreatic malignancy, detected with subclinical liver function tests following diagnosis of CAR. Biopsy showed a T2N0M0 ampullary adenocarcinoma. The patient was managed with Whipple’s procedure and adjuvant chemotherapy and has made a good recovery with no progression of her retinopathy. To our knowledge, this is one of the first descriptions of CAR in the context of pancreatic malignancy. It is atypical in its asymmetric presentation and favourable patient outcome. 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| subjects | Adenocarcinoma - complications Ampulla of Vater Bile Cancer Case reports Cataracts Endoscopy Eye surgery Female Field study Humans Immunoglobulins Middle Aged ophthalmology Pancreatic cancer Pancreatic Neoplasms - complications Photoreceptors retina Retinal Diseases - etiology Unexpected Outcome (Positive or Negative) Including Adverse Drug Reactions Vision Disorders - etiology |
| title | Cancer-associated retinopathy in ampullary pancreatic cancer |
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