Kate E Leahy1, Tanya Karaconji2, Valli Thanni3, Anita Achan3, Adrian T Fung4. 1. Department of Ophthalmology, Institute for Clinical Pathology and Medical Research, Westmead Hospital, N.S.W., Australia. 2. Department of Ophthalmology, Institute for Clinical Pathology and Medical Research, Westmead Hospital, N.S.W., Australia; Department of Sydney Eye Hospital, University of Sydney, N.S.W., Australia. 3. Department of Anatomical Pathology, Institute for Clinical Pathology and Medical Research, Westmead Hospital, N.S.W., Australia. 4. Department of Anatomical Pathology, Institute for Clinical Pathology and Medical Research, Westmead Hospital, N.S.W., Australia; Department of Sydney Eye Hospital, University of Sydney, N.S.W., Australia; Department of Save Sight Institute, University of Sydney, N.S.W., Australia; Department of Australian School of Advanced Medicine, Macquarie University, Sydney, N.S.W., Australia.
Abstract
AIM: To report a case of metastatic small-cell neuroendocrine carcinoma presenting as an isolated choroidal mass and initially misdiagnosed as a circumscribed choroidal hemangioma. METHODS: The clinical history, fundus findings, imaging, cytology and immunohistochemical features are described. RESULTS: An otherwise healthy 66-year-old man was referred for a left nasal scotoma and a diagnosis of circumscribed choroidal hemangioma. Cytology showed cohesive clusters of small-to-intermediate malignant cells. The atypical cells stained positively for chromogranin, thyroid transcription factor-1 and synaptophysin consistent with small-cell neuroendocrine carcinoma. CONCLUSION: Small-cell neuroendocrine carcinoma metastatic to the choroid is extremely rare; however, it is particularly aggressive and should be included in the differential diagnosis of isolated choroidal lesions, even in otherwise healthy patients.
AIM: To report a case of metastatic small-cell neuroendocrine carcinoma presenting as an isolated choroidal mass and initially misdiagnosed as a circumscribed choroidal hemangioma. METHODS: The clinical history, fundus findings, imaging, cytology and immunohistochemical features are described. RESULTS: An otherwise healthy 66-year-old man was referred for a left nasal scotoma and a diagnosis of circumscribed choroidal hemangioma. Cytology showed cohesive clusters of small-to-intermediate malignant cells. The atypical cells stained positively for chromogranin, thyroid transcription factor-1 and synaptophysin consistent with small-cell neuroendocrine carcinoma. CONCLUSION: Small-cell neuroendocrine carcinoma metastatic to the choroid is extremely rare; however, it is particularly aggressive and should be included in the differential diagnosis of isolated choroidal lesions, even in otherwise healthy patients.