Unusual choroidal mass

We present a unique case of disseminated tuberculosis presenting initially in the eye solely as a choroidal mass without any inflammation, mimicking choroidal metastasis. A 19-year-old girl presented with a large choroidal mass lesion in the right eye. Systemic examination revealed axillary lymphadenopathy. A fundus fluorescein angiography, positron emission tomography scan, abdominal ultrasonography and raised biochemical markers such as serum CA-125 pointed towards the diagnosis of choroidal metastases with primary in the ovaries. Fine needle aspiration cytology of the adnexal mass and ascitic fluid revealed granulomatous inflammation with a negative acid-fast bacilli stain. A multiplex PCR of ascitic fluid for the sequence MPB64 and IS6110 was positive for tuberculosis. The final diagnosis of disseminated tuberculosis was made and the patient subsequently showed a good response to antitubercular therapy.