Iris metastasis preceding diagnosis of gastric signet ring cell adenocarcinoma: a case report

BACKGROUND: A case of iris metastasis preceding the diagnosis of gastric signet ring cell adenocarcinoma is very rare. To report the findings in a patient who presented with an iris tumor that was later identified to have metastasized from a gastric signet ring cell adenocarcinoma. CASE PRESENTATION: A-74-year-old woman presented with visual disturbance and an increased intraocular pressure (IOP) in the right eye. She had no history of systemic cancer. She was initially diagnosed with acute iritis from diabetes mellitus and secondary glaucoma. She underwent trabeculectomy because of the uncontrolled IOP. After the IOP was controlled, she presented thick iris with corectopia, iris hemorrhage, and white, frog spawn-like mass resembling fibrin in the anterior chamber. An analysis of an iris biopsy suggested that the iris mass was an adenocarcinoma. Examination by esophagogastroduodenoscopy revealed advanced gastric signet ring cell adenocarcinoma as the primary source for the iris tumor. CONCLUSIONS: We recommend that patients with acute iritis with atypical iris mass resembling fibrin and secondary glaucoma should be examined comprehensively for systemic tumors.