J Korean Ophthalmol Soc.  2015 Sep;56(9):1464-1466. 10.3341/jkos.2015.56.9.1464.

Pigmented Choroidal Metastases Masquerading as Choroidal Melanoma

• Shin WB
• Kim MK
• Kim JY
• Lee SC
• Kim HS

• KMID: 2214565
• DOI: http://doi.org/10.3341/jkos.2015.56.9.1464

Abstract

PURPOSE
To report the first case of pigmented choroidal metastases without enucleation diagnosed with fine-needle aspiration biopsy.
CASE SUMMARY
A 47-year-old male was referred to our clinic with a suspected diagnosis of choroidal melanoma in his left eye. Positron emission tomography-computer tomography used to evaluate systemic metastases revealed lung cancer. Pathology of the detected lung mass was primary lung neuroendocrine tumor. To differentiate choroidal metastasis and primary choroidal melanoma, we performed a fine-needle aspiration biopsy for choroidal tumors. The cytology showed results favoring metastatic atypical carcinoid and the patient was started on systemic chemotherapy.
CONCLUSIONS
All pigmented choroidal tumors are not choroidal melanomas and choroidal metastases may be pigmented. The present case suggests that proper systemic evaluation and biopsy for suspected choroidal tumor could be helpful in diagnosis.

Keyword

Carcinoid tumors; Choroidal melanoma; Choroidal metastases; Lung neuroendocrine tumor

MeSH Terms

Biopsy
Biopsy, Fine-Needle
Carcinoid Tumor
Choroid*
Diagnosis
Drug Therapy
Electrons
Humans
Lung
Lung Neoplasms
Male
Melanoma*
Middle Aged
Neoplasm Metastasis*
Neuroendocrine Tumors
Pathology

Figure

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  Figure 1. (A) Fundus photography shows two dark choroidal tumors with subretinal hemorrhages. (B) Fluorescein angiography on late phase shows staining at the location of tumors and diffuse vascular leakages throughout entire retina. (C) Magnetic resonance imaging (MRI) shows hyperintense plaque-like intraocular masses on T1 weighted image (arrows). (D) On T2 weighted image of MRI, intraocular masses show hypointense signal (arrows).

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  Figure 2 . Cytology from choroidal tumor. Cytology from fine-needle aspiration biopsy shows moderate to marked pleo-morphism with inconspicuous nucleoli and indicates that choroi-dal lesions are identical with pulmonary lesion (H&E, ×200).

Reference

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