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In fast-growing carcinomas, metastatic ocular symptoms can appear before primary tumor diagnosis.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/blurred-vision-as-the-first-symptom-of-pancreatic-cancer-case-report/355644/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/blurred-vision-as-the-first-symptom-of-pancreatic-cancer-case-report/355644.png","ImageObject",300,407,{"name":42,"@type":43},"Melati","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-23","2026-09-22",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",7,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"How did the patient initially present in this case?","Question",{"text":63,"@type":64},"The patient in her 60s was referred for right-eye visual impairment. Best-corrected visual acuity declined in the right eye, and ophthalmoscopy showed a slightly elevated macular lesion.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What was found during screening for a primary tumor?",{"text":68,"@type":64},"Primary tumor screening identified a malignant mass in the cauda of the pancreas. Further imaging showed pulmonary metastases and involved lymph nodes.",{"name":70,"@type":61,"acceptedAnswer":71},"Why is blurred vision important in pancreatic cancer diagnosis?",{"text":72,"@type":64},"Eye metastasis, particularly to the choroid, can be the first sign of a distant malignancy. The report highlights that intraocular manifestations may precede detection of the primary tumor, especially when lesions are small or not characteristic.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},355644,1790198474,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,109,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":107,"slug":108},40,"healthcare",{"id":110,"doc_module":4,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},8,"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":55,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":97,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":144},962085570644,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","Case report  \nBlurred vision as the first symptom of pancreatic cancer  \nDorottya Pasztor  , 1 Eszter Zöld  , 1 Éva Szekanecz  ,2 Sarolta Molnár  ,3 Nikolaos E Bechrakis,4 Eva Suranyi  1  \n1Department of Ophthalmology, University of Debrecen, Debrecen, Hungary 2Department of Oncology, University of Debrecen, Debrecen, Hungary 3Department of Pathology, University of Debrecen, Debrecen, Hungary 4Department of Ophthalmology, University of Duisburg-Essen  \nUniversity Hospital Essen, Essen, NRW, Germany  \nCorrespondence to  \nDr Eva Suranyi;  \n[suranyieva@hotmail.com](suranyieva@hotmail.com)  \nAccepted 9 April 2026  \n© BMJ Publishing Group Limited 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.  \nTo cite: Pasztor D, Zöld E, Szekanecz É, et al. BMJ Case Rep 2026;19:e267417 . doi:10 . 1136/bcr-2025- 267417  \nSUMMARY  \nThis study presents a case and literature review of blurred vision as the first symptom of pancreatic cancer. A woman in her 60s was referred to our clinic because of visual impairment in her right eye. Ophthalmoscopic examination revealed a slightly elevated lesion in themacula. Primary tumour screening found a malignant mass in the cauda of the pancreas.  \nAccording to Shields et al, pancreatic cancer with uveal metastasis has one of the least favourable survival rates. Our patient survived 20 months after the appearance of ophthalmic symptoms and had a good quality of life for a relatively long time. After reviewing all published data on intraocular metastases of pancreatic cancer, it becomes evident that the detection of the intraocular manifestation precedes the detection of the primary in half of the cases.  \nApparently, in fast-growing carcinomas, the symptomatology of the metastatic manifestation can precede the detection of the primary tumour.  \nBACKGROUND  \nMetastasis to the eye and specifically to thechoroid can be the first manifestation of a distant tumour disease.1–5 The most common primary tumours are breast, lung and prostate cancers.3–6 The dominant symptom in primary ocular manifestations is blurred vision and/ or visual field defects, which can be the first sign of malignancy in one-third of the cases. It would be important for both ophthalmologists and general medical practitioners to be aware of this possibility to avoid unnecessary delaysin primary tumour detection, considering that detection of both primary and metastatic manifestations can be challenging, especially when the lesions are small and not characteristic in appearance. The most frequent tumour metastatic to the choroid is breast cancer (37%), followed by the lung (27%), gastrointestinal tract (4%), kidney (4%), prostate (2%) and skin (2%) .3 5 Primary pancreatic carcinoma asthe site of origin for intraocular metastasis is extremely rare and has been described only a few times.3 5 7–17  \nPancreatic cancer is the 14th most common cancer, usually diagnosed at an advanced stage resulting in a very poor prognosis, with a 5-year survival rate of less than 10% and the seventh highest cause of cancer death worldwide.8 10 It is observed that the incidence is increasing, predicting that pancreatic cancer will become  \nFigure 1 Fundus view on presentation showing anamelanotic mass at the macular region with a small melanocytic choroidal nevus at its lower margin (white asterisk) .  \nthe second-leading cause of tumour-related mortality by 2030 in the USA.  \nCASE PRESENTATION  \nA woman in her 60s was referred to our clinic because of visual impairment in her right eye. In the general medical history, there were type 2 diabetes treated with insulin (HbA1C 7. 1%), hypothyroidism, anti-HCV positive chronic hepatitis, controlled paroxysmal supraventricular tachycardia, coronary stent due to stenosis and COVID-19 infection 11 months earlier (she received two vaccinations after that) . She had an upper respiratory tract infection with fever and hearing loss several weeks before the onset of ","cbCaieeM6rZ85vSx","https://ap.wps.com/l/cbCaieeM6rZ85vSx","pdf",1051437,"English","# SUMMARY\n# BACKGROUND\n# CASE PRESENTATION\n# INVESTIGATIONS","[{\"question\":\"How did the patient initially present in this case?\",\"answer\":\"The patient in her 60s was referred for right-eye visual impairment. Best-corrected visual acuity declined in the right eye, and ophthalmoscopy showed a slightly elevated macular lesion.\"},{\"question\":\"What was found during screening for a primary tumor?\",\"answer\":\"Primary tumor screening identified a malignant mass in the cauda of the pancreas. Further imaging showed pulmonary metastases and involved lymph nodes.\"},{\"question\":\"Why is blurred vision important in pancreatic cancer diagnosis?\",\"answer\":\"Eye metastasis, particularly to the choroid, can be the first sign of a distant malignancy. The report highlights that intraocular manifestations may precede detection of the primary tumor, especially when lesions are small or not characteristic.\"}]","Blurred vision as the first symptom of pancreatic cancer - Case report | PDF",1790120265,13]