Late-stage metastasis to the choroid from follicular thyroid carcinoma--case report

Metastatic tumors to the choroid represent the most common uveal malignancy in adults. The most common origin of choroidal metastasis is from the breast and lung. Choroidal metastasis from thyroid carcinoma is rare. We report a case of choroidal metastasis that presented 36 years after the patient was initially diagnosed with follicular thyroid carcinoma.

A 74-year-old Afro-Caribbean woman with nonproliferative diabetic retinopathy presented to the diabetic clinic for a routine 6-month review. A dilated fundus examination found bilateral background diabetic retinopathy and a large metastatic lesion in the periphery of the right eye. Ocular ultrasonography was performed. The patient had undergone partial thyroidectomy for nodular goiter in 1969. Biopsy of skeletal metastases in 1982 confirmed that the primary was follicular thyroid carcinoma. She died 9 months after presentation with choroidal metastasis from progressive metastatic disease.

Choroidal metastasis may appear in the late stage of a very long period of known thyroid metastatic disease. It can develop fairly rapidly without causing any ocular symptoms.