Supplementary Material for: A case of metastatic iris tumor from adenocarcinoma of the cecum diagnosed by combined tumor markers in aqueous humor and fine needle aspiration cytology

Background/Aim: The diagnosis of metastatic iris tumor is made by a fine needle aspiration biopsy of part of the solid component of the tumor and tumor cells seeded in the anterior chamber; however, sometimes the diagnosis is not made due to insufficient sample volumes. We report a case of metastatic iris tumor in which measurement of tumor marker levels in the aqueous humor together with fine needle aspiration cytology contributed to the diagnosis.
Case Report: An 80-year-old Japanese woman was referred to our hospital because of an iris mass. Six months before the initial visit, the patient was diagnosed with adenocarcinoma of the cecum. Slit-lamp microscopy revealed an elevated iris mass. Fine needle aspiration cytology suggested adenocarcinoma. The carcinoembryonic antigen (CEA) level in the anterior chamber was 5716.1 ng/ml, and serum CEA level measured on the same day were 678.5 ng/ml. These data indicated CEA levels synchronously elevated in both anterior chamber and serum. Based on aspiration cytology and high CEA levels of anterior chamber, she was diagnosed with metastatic iris tumor derived from adenocarcinoma of the cecum. One month after the initial visit, right eye irradiation was performed for metastatic iris tumor.
Conclusion: Measurement of tumor marker levels in the aqueous humor, together with fine needle aspiration cytology of the tumor, contributes to the diagnosis of metastatic iris tumors.

背景/目的：虹膜转移肿瘤的诊断通过肿瘤实质性部分及肿瘤细胞在眼前房中的细针穿刺活检来完成；然而，由于样本量不足，有时诊断无法确定。本报告介绍了一例虹膜转移肿瘤的病例，其中，测量房水中的肿瘤标志物水平与细针穿刺细胞学检查共同有助于诊断。
病例报告：一位80岁的日本女性因虹膜肿块被转诊至我院。在首次就诊前六个月，患者被诊断为回肠腺癌。裂隙灯显微镜检查显示虹膜肿块。细针穿刺细胞学检查提示腺癌。眼前房中的癌胚抗原（CEA）水平为5716.1 ng/ml，同日测量的血清CEA水平为678.5 ng/ml。这些数据显示，眼前房和血清中的CEA水平同步升高。基于穿刺细胞学检查和眼前房高CEA水平，她被诊断为起源于回肠腺癌的转移性虹膜肿瘤。在首次就诊后一个月，对转移性虹膜肿瘤进行了右眼放射治疗。
结论：房水中的肿瘤标志物水平测量以及肿瘤的细针穿刺细胞学检查，共同有助于转移性虹膜肿瘤的诊断。