BACKGROUND We report a case of a patient with iris metastasis as the initial manifestation of a systemic cancer: upper gastrointestinal tract carcinoma. CASE PRESENTATION A 24-year-old Asian man presented to our hospital with complaints of red left eye, decreased visual acuity, pain, and photophobia for about 3 weeks with no prior history of cancer or any other medical abnormality. Ocular examination showed a pinkish white lesion on the superonasal part of the iris. The patient's intraocular pressure was progressively increasing despite medications, followed by lymphadenopathy 4 weeks later. Comprehensive examination was performed along with a complete systemic workup, which detected systemic malignancy. Histopathology and immunohistochemistry revealed signet ring cells, which indicated an upper gastrointestinal tract tumor as a primary source of iris metastasis. The systemic condition of the patient deteriorated rapidly thereafter and led to his death in the 12th week of the disease. CONCLUSION A red eye with iris lesions in otherwise healthy individuals should be considered as a possible initial manifestation of underlying systemic malignancy. Prompt referral of such patients to an oncologist is warranted.

中文翻译：

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虹膜转移是上消化道癌的初步表现：一例报告。

背景技术我们报道了一例虹膜转移患者，它是系统性癌症的上位表现：上消化道癌。病例介绍一名24岁的亚洲男子因左眼红肿，视力下降，疼痛和畏光感出现在我们的医院约3周，无先前的癌症病史或其他任何医学异常情况。眼科检查显示虹膜上鼻部分有粉红色白色病变。尽管用药，患者的眼内压逐渐升高，随后4周后出现淋巴结肿大。进行了全面检查，并进行了全身性检查，发现了系统性恶性肿瘤。组织病理学和免疫组化显示印戒细胞，这表明上消化道肿瘤是虹膜转移的主要来源。此后患者的全身状况迅速恶化，并在疾病的第12周死亡。结论在其他健康人群中，虹膜病变的红眼应被视为潜在的系统性恶性肿瘤的初步表现。此类患者应立即转诊给肿瘤科医生。