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Abstract
Case summary
A 75-year-old man with over a 50 pack-year history of smoking presented discomfort and visual dis-turbance of the left eye for several months. His best-corrected visual acuity was 0.3, intraocular pressure was 9 mm Hg, and extraocular movements were normal. Slit-lamp examinations revealed no specific findings in the anterior segment in the left eye. However, retinal exams showed an oval-shaped, juxtapapillary mass-like lesion associated with retinal folding in the left eye. A huge, distorted echoic mass with an initial prominent spike and low-to-medium internal reflectivity with diminishing amplitude was observed on ocular ultrasonography. Enhanced CT revealed a highly-intense, irregular-circumscribed heterogeneous mass (2.0 × 2.0 × 1.5) in the superomedial quadrant of the left eye. Metastatic workups, including bone scan and CT of the head, neck, chest, and abdomen, were unremarkable. One week after the initial visit, the patient experienced pain and reduced visual acuity (light perception) in the left eye. Following the diagnosis, enucleation with tumor resection and hydroxyapatite implantation was performed. Histopathologic examination revealed a moderated-differentiated squamous cell carcinoma invading the sclera. The patient subsequently underwent radiation treatment and no evidence of recurrence was reported 6 months after surgery.
References
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Figure 2.
An oval shaped, juxtapapillary mass-like lesion with retinal foldings but without dark pigmentations, dragging of retinal vessels, or exudative retinal detachment can be observed.
Figure 3.
(A). On B-scan, a large mass with distorted echotexture can be seen. A-scan shows an initial prominent spike followed by a low-to-medium internal reflectivity with diminishing amplitude. (B, C) Enhanced axial CT demonstrated a highly-intense, irregularly- circumscribed heterogenous mass (2.0×2.0×1.5 cm sized) in the superomedial quadrant of the left eye.
Figure 5.
(A) Histopathology shows moderately-differentiated squamous cell carcinoma with keratinization (arrow) surrounded by inflammatory cells (asterisk) of lymphocytes, macrophages, neutrophils, eosinophils, and plasma cells (hematoxylin-eosin, ×20). (B) High power view showing numerous pleomorphic cell with hyperchromasia and atypical mitotic figures (hematoxylin-eosin, ×100). (C) Histopathology shows invasion of the sclera (arrow) (hematoxylin-eosin, ×4).
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