Refractory Nodular Scleritis as a Presenting Sign of Colorectal Cancer.

IF 2.6 4区医学 Q2 OPHTHALMOLOGY

Ocular Immunology and Inflammation Pub Date : 2025-04-23 DOI:10.1080/09273948.2025.2495069

Rahime Duran, Yiğit Kıran, Kübra Özdemir Yalçınsoy, Ertuğrul Çağrı Bölek, Abdulsamet Erden

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Abstract

Purpose: To describe a rare case of recurrent anterior nodular scleritis as the initial manifestation of paraneoplastic syndrome in a patient with colorectal cancer.

Methods: A case report of a 47-year-old female with a history of acute lymphoblastic leukemia who presented with ocular pain, redness, and blurred vision in her right eye. Despite treatment with corticosteroids and methotrexate, the patient experienced monthly recurrences of scleritis. A comprehensive work-up was conducted to investigate the underlying systemic disease.

Results: Laboratory investigations revealed iron deficiency anemia and elevated inflammatory markers. Abdominal CT, followed by colonoscopy, revealed an ulcerovegetative mass at the splenic flexure. The patient underwent a left hemicolectomy. Pathological examination of the resected specimen confirmed the diagnosis of a mucinous adenocarcinoma. No recurrence of scleritis was observed after surgery.

Conclusion: This case highlights the importance of considering paraneoplastic syndrome in the differential diagnosis of unexplained or refractory scleritis, especially in elderly patients. A multidisciplinary diagnostic approach is essential to identify and manage such paraneoplastic manifestations.

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顽固性结节性巩膜炎是结直肠癌的表现之一。

目的：报道一例罕见的以复发性前结节性巩膜炎为副肿瘤综合征首发表现的结直肠癌患者。方法：本文报告一位47岁女性，有急性淋巴细胞白血病病史，表现为右眼疼痛、红肿、视力模糊。尽管接受了皮质类固醇和甲氨蝶呤治疗，患者仍经历了每月一次的巩膜炎复发。进行了全面的检查以调查潜在的全身性疾病。结果：实验室检查显示缺铁性贫血和炎症标志物升高。腹部CT及结肠镜检查显示在脾屈曲处有一植性溃疡肿块。病人接受了左结肠切除术。切除标本的病理检查证实了粘液腺癌的诊断。术后无巩膜炎复发。结论：本病例强调了在不明原因或难治性巩膜炎的鉴别诊断中考虑副肿瘤综合征的重要性，特别是在老年患者中。多学科的诊断方法是必不可少的，以确定和管理这些副肿瘤的表现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ocular Immunology and Inflammation 医学-眼科学

CiteScore

6.20

自引率

15.20%

发文量

285

审稿时长

6-12 weeks

期刊介绍： Ocular Immunology & Inflammation ranks 18 out of 59 in the Ophthalmology Category.Ocular Immunology and Inflammation is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and vision scientists. Published bimonthly, the journal provides an international medium for basic and clinical research reports on the ocular inflammatory response and its control by the immune system. The journal publishes original research papers, case reports, reviews, letters to the editor, meeting abstracts, and invited editorials.