There's Always a Bigger Fish.

Ocul Immunol Inflamm

Department of Ophthalmology, Sorbonne University, Pitiè-Salpêtrière Hospital, Paris, France.

Published: September 2025


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Article Abstract

Purpose: To report a rare case of cancer-associated retinopathy (CAR) presenting initially as a bilateral acute vision loss in a 72-year-old female patient with a history of tongue carcinoma. Systemic work-up revealed a metastatic uterine neuroendocrine carcinoma.

Methods: Case report describing clinical presentation and diagnostic work up in a patient with CAR syndrome.

Results: A 72-year-old female patient was referred for bilateral acute severe vision loss immediately after axillary node dissection in the context of a tongue carcinoma. Ophthalmological examination revealed rapidly evolutive outer retinal atrophy, with acute severe vision loss to light perception in both eyes within a few days. CAR-syndrome was suspected in this patient with tongue carcinoma and a positive sentinel lymph node. However, a systemic work-up revealed a metastatic tumor of the uterine body.Despite high-dose systemic corticosteroids, plasmapheresis, and chemotherapy, she did not present any functional recovery.

Conclusion: CAR-syndrome may precede the diagnosis of the associated tumor. Thorough medical history, extensive work-up is the key in order not to miss the primitive lesion causative of the CAR syndrome, even in patients with another known malignancy.

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http://dx.doi.org/10.1080/09273948.2025.2504581DOI Listing

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