Pigmented Choroidal Metastases Masquerading as Choroidal Melanoma

Woo Beom Shin; Min Kyo Kim; Ji Ye Kim; Sung Chul Lee; Hye Sun Kim

doi:10.3341/jkos.2015.56.9.1464

Journal List > J Korean Ophthalmol Soc > v.56(9) > 1010095

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Shin, Kim, Kim, Lee, and Kim: Pigmented Choroidal Metastases Masquerading as Choroidal Melanoma

Original Article

J Korean Ophthalmol Soc 2015;56(9):1464-1466.

Published online: 29 August 2015

DOI: https://doi.org/10.3341/jkos.2015.56.9.1464

Pigmented Choroidal Metastases Masquerading as Choroidal Melanoma

Woo Beom Shin, M.D^1,², Min Kyo Kim, M.D^1,², Ji Ye Kim, M.D³, Sung Chul Lee, M.D, PhD¹, Hye Sun Kim, M.D^2,

¹The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine^¹, Seoul, Korea

²Siloam Eye Hospital, Seoul, Korea

³Department of Pathology, Severance Hospital, Yonsei University College of Medicine , Seoul, Korea

Address reprint requests to Hye Sun Kim, MD Siloam Eye Hospital, #181 Deungchon-ro, Gangseo-gu, Seoul 07668, Korea Tel: 82-2-2650-0880, Fax: 82-2-2650-0895 E-mail: capella0226@gmail.com

Received 27 March 201515 May 2015 Accepted 10 July 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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 mel-anoma, 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. J Korean Ophthalmol Soc 2015;56(9):1464-1466

Keywords: Carcinoid tumors, Choroidal melanoma, Choroidal metastases, Lung neuroendocrine tumor

References

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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).

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).

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