Abstract
We herein report a case of right orbital metastasis from gastric cancer developed after curable gastrectomy. The case involved a 57-year-old man who underwent laparoscopic proximal gastrectomy combined with D1 plus lymphadenectomy for gastric cancer in the upper third of the stomach in April 2014. Histopathologically, the gastric adenocarcinoma was classified as T3(SS)N3bM0, Stage IIIB cancer. Eight cycles of S1 monotherapy (100 mg/body/day) were administered for adjuvant chemotherapy. He visited an ophthalmological clinic presented with hyperemia, exophthalmos, and pain of the right eye 15 months after the gastrectomy. Brain CT scan revealed an enhanced soft tissue in the right-sided orbit. An orbital biopsy under local anesthesia showed a pathological diagnosis of adenocarcinoma which was similar to the primary adenocarcinoma of the stomach. This finding was compatible with orbital metastasis from gastric adenocarcinoma. Chemoradiotherapy with oral S1 administration (100 mg/day/body conforming with irradiation date) and radiation at 50 Gray (2 Gray/25 Fraction) was performed for the orbital metastasis. His eye symptoms improved gradually and a partial response was achieved after the chemoradiotherapy. However, he died from leptomeningeal carcinomatosis seven months after the diagnosis of orbital metastasis. Orbital metastasis from gastric cancer is extremely rare, and we report details of our case with a review of the literature.
